Individual provider Active NPI

Philip Preston Stewart, D.O.

  • Internal Medicine Physician
  • Cullman, AL
National Provider Identifier
1457639650
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO1284 Issued in AL
Practice address
1912 Al Highway 157
Cullman, AL 35058-0609
Phone
(256) 737-2682
Fax
(256) 737-2152
NPI assigned
Jul 22, 2011
Last updated
Sep 23, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DO1284 AL Primary

Addresses

Primary practice location

1912 Al Highway 157
Cullman, AL 35058-0609

Mailing address

PO Box 2895
Cullman, AL 35056-2895
Phone (256) 737-2682

Other practice location 1

812 Humes Ave NE
Huntsville, AL 35801-2902
Phone (205) 532-4660

Other identifiers 1

IdentifierTypeStateIssuer
198058MedicaidAL

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
I20120802000451 AL Practitioner - Internal Medicine 9537315809 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Kansas City University of Physicians and Surgeons, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastside Family MedicineGroup PAC ID 9032494935, 2 clinicians

Practice addresses (Care Compare)

22289 Medical Village Dr
Athens, AL 35613-2896
Phone (256) 232-1414

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO1284ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ecm Health Group LLC CurrentSince Apr 1, 2017 Accepting new patients
Eastside Family Medicine CurrentSince May 1, 2025 Accepting new patients

Locations

22289 Medical Village Dr
Athens, AL 35613
Phone (256) 232-1414

541 W College St
Ste 3200
Florence, AL 35630
Phone (256) 760-0098

541 W College St
Ste 3300
Florence, AL 35630
Phone (256) 766-6026

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1311292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1457639650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2895",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350562895",
            "telephone_number": "256-737-2682",
            "fax_number": "256-737-2152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1912 AL HIGHWAY 157",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350580609",
            "telephone_number": "256-737-2682",
            "fax_number": "256-737-2152"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "812 Humes Ave NE",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "AL",
            "postal_code": "358012902",
            "country_code": "US",
            "telephone_number": "205-532-4660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEWART",
        "first_name": "PHILIP",
        "middle_name": "PRESTON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-22",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "DO1284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198058",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cullman, AL

Sources for this page

Verify at the official NPI Registry.