Individual provider Active NPI

Stephanie D Reilly, MD

  • Anatomic Pathology Physician
  • Birmingham, AL
National Provider Identifier
1255356390
Registry record updated Sep 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
15633 Issued in AL
Practice address
619 19TH Street South
Birmingham, AL 35233
Phone
(205) 934-6600
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 15633 AL Primary

Addresses

Primary practice location

619 19TH Street South
Birmingham, AL 35233

Mailing address

PO Box 55310
Birmingham, AL 35255-5310
Phone (205) 731-9701

Other identifiers 4

IdentifierTypeStateIssuer
010033CG92757OtherALSECTION 1011
000006658OtherALBLUE CROSS
000006658MedicaidAL
G92757OtherALVIVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15633ALMDAnatomic Pathology Physician

Interoperability endpoints

  • Direct secure messaging: sdreilly@direct.uabmedicine.org

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315440000000",
    "number": "1255356390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55310",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352555310",
            "telephone_number": "205-731-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 19TH STREET SOUTH",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35233",
            "telephone_number": "205-934-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "STEPHANIE",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2011-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "AL",
            "license": "15633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECTION 1011",
            "identifier": "010033CG92757",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000006658",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000006658",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIVA",
            "identifier": "G92757",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.