Individual provider Active NPI

Stephan G. Moran, MD

  • Surgical Critical Care Physician
  • Huntsville, AL
National Provider Identifier
1417922683
Registry record updated Jul 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
00021195 Issued in AL
Practice address
201 Sivley Rd SW
Suite 400
Huntsville, AL 35801-5134
Phone
(256) 265-2895
Fax
(256) 265-9777
NPI assigned
Feb 21, 2006
Last updated
Jul 22, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X 00021195 AL Primary
Trauma Surgery Physician 2086S0127X 00021195 AL

Addresses

Primary practice location

201 Sivley Rd SW
Suite 400
Huntsville, AL 35801-5134

Mailing address

PO Box 2705
Huntsville, AL 35804-2705
Phone (256) 265-4595

Other identifiers 4

IdentifierTypeStateIssuer
4086146OtherTNBCBS
051520526OtherALBCBS
4046898MedicaidTN
009947965MedicaidAL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040522000071 AL Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 1153312624 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00021195ALMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Alabama Specialty Hospital CurrentSince Aug 23, 2021 Accepting new patients
The Health Care Authority for Baptist Health, an Affiliate of Uabhs CurrentSince Jun 26, 2017 Accepting new patients
North Alabama Specialty Hospital CurrentSince Aug 23, 2021 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Surgical Critical Care Past Accepting new patients
The Health Care Authority for Baptist Health Past Accepting new patients

Locations

107 Governors Dr SW
Huntsville, AL 35801
Phone (256) 417-9986

2055 E South Blvd
Ste 308
Montgomery, AL 36116
Phone (334) 286-2390

2055 E South Blvd
Ste 601
Montgomery, AL 36116
Phone (334) 281-9000

301 Brown Springs Rd
Montgomery, AL 36117
Phone (334) 273-4159

1000 Chinaberry Dr
Ste 200
Bossier City, LA 71111

Interoperability endpoints

  • Direct secure messaging: stephen.moran@direct.baptistfirst.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437523200000",
    "number": "1417922683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2705",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358042705",
            "telephone_number": "256-265-4595",
            "fax_number": "256-265-4599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SIVLEY RD SW",
            "address_2": "SUITE 400",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015134",
            "telephone_number": "256-265-2895",
            "fax_number": "256-265-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "STEPHAN",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2015-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "AL",
            "license": "00021195",
            "primary": true
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "AL",
            "license": "00021195",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4086146",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051520526",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4046898",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009947965",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.