Individual provider Active NPI

Brittany Leigh Stam, M.D.

  • Obstetrics & Gynecology Physician
  • Show Low, AZ
National Provider Identifier
1295046985
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
49108 Issued in AZ
Practice address
5171 S Cub Lake Rd Ste C340
Show Low, AZ 85901-7877
Phone
(480) 821-3600
Fax
(480) 857-2667
NPI assigned
Jun 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 49108 AZ Primary

Addresses

Primary practice location

5171 S Cub Lake Rd Ste C340
Show Low, AZ 85901-7877

Mailing address

PO Box 6730
Chandler, AZ 85246-6730
Phone (480) 821-3600

Other identifiers 1

IdentifierTypeStateIssuer
944250MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20141015000486 AZ Practitioner - Obstetrics/Gynecology 4981825023 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Momdoc LLCGroup PAC ID 3375534282, 62 clinicians

Practice addresses (Care Compare)

5171 S Cub Lake Rd
Suite 340 BLDG C
Show Low, AZ 85901-7888
Phone (480) 821-3600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49108AZMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Pregnancy Perinatology, LLC PastSince Nov 19, 2023 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1295046985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6730",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852466730",
            "telephone_number": "480-821-3600",
            "fax_number": "480-857-2667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5171 S CUB LAKE RD STE C340",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017877",
            "telephone_number": "480-821-3600",
            "fax_number": "480-857-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAM",
        "first_name": "BRITTANY",
        "middle_name": "LEIGH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-28",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "49108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "944250",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Show Low, AZ

Sources for this page

Verify at the official NPI Registry.