Stephen Anthony Kahalley, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

00009877 Issued in AL

Practice address

610 Providence Park Dr E
BLDG 1 Suite 102
Mobile, AL 36695-4622

Phone

(251) 378-3900

Fax

(251) 378-3901

NPI assigned

Jul 27, 2006

Last updated

Jun 3, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alabama Providence Healthcare Services

  dba Providence Medical Group

  • Internal Medicine Physician
  • Mobile, AL
  • NPI 1245669514
  Medicare reassignment NPD
• Providence Hospital

  • General Acute Care Hospital
  • Mobile, AL
  • NPI 1952390643
  Medicare reassignment NPD
• Alabama Providence Healthcare Services

  dba Ascension Providence Diabetes Management Program

  • Endocrinology, Diabetes & Metabolism Physician
  • Mobile, AL
  • NPI 1609446087
  NPD
• Providence Hospital

  • Anesthesiology Physician
  • Mobile, AL
  • NPI 1992133912
  NPD
• University of South Alabama Health Services Foundation

  dba USA Clinical Genetics Lab

  • Clinical Medical Laboratory
  • Mobile, AL
  • NPI 1548357916
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1255345369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850489",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366850489",
            "telephone_number": "251-342-3949",
            "fax_number": "251-631-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 PROVIDENCE PARK DR E",
            "address_2": "BLDG 1 SUITE 102",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366954622",
            "telephone_number": "251-378-3900",
            "fax_number": "251-378-3901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6701 Airport Blvd Ste A206",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366083763",
            "country_code": "US",
            "telephone_number": "251-675-7433",
            "fax_number": "251-675-3470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAHALLEY",
        "first_name": "STEPHEN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "00009877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AL MEDICAID",
            "identifier": "000093042",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "11217512",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0410743",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL",
            "identifier": "51093042",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phyllus J Justice, R.D.
• Wiley Hugh Justice, M.D.
• Rachel Kabazzi, M.D.
• Roy Edward Kadel, DC
• Jessica Kaercher
• Aleen Sarah Kaltakdjian, OD
• Olivia Kalu, M.D.
• Neema Kamau, DO
• Prathima Ramaswami Kannan, RDN
• Shantha R Kannan, MD

• Internal Medicine Physician in Mobile, AL
• Providers in Mobile, AL by specialty
• Internal Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.