Individual provider Active NPI

Michael O Stodard, M.D.

  • Family Medicine Physician
  • Daphne, AL
National Provider Identifier
1538187885
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD34796 Issued in AL
Practice address
1208 US Highway 98
Daphne, AL 36526-4254
Phone
(251) 626-5377
NPI assigned
Jul 17, 2006
Last updated
Mar 4, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 09655 MS
Family Medicine Physician 207Q00000X MD34796 AL Primary

Addresses

Primary practice location

1208 US Highway 98
Daphne, AL 36526-4254

Mailing address

1208 US Highway 98
Daphne, AL 36526-4254
Phone (251) 626-5377

Other identifiers 3

IdentifierTypeStateIssuer
730-13088OtherALBLUE CROSS BLUE SHIELD
00015240MedicaidMS
009965870MedicaidAL

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
I20170427001475 AL Practitioner - Family Practice 4284728825 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care by the Bay, LLCGroup PAC ID 4284811522, 11 clinicians

Practice addresses (Care Compare)

1208 US Hwy 98
Daphne, AL 36526-4254
Phone (251) 626-5377

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
09655MSMDEmergency Medicine Physician
MD34796ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care by the Bay, LLC Emergency Medicine CurrentSince Apr 2, 2018 Accepting new patients
American Family Care, LLC CurrentSince Mar 5, 2017 Accepting new patients
American Family Care, LLC Family Medicine CurrentSince Mar 5, 2017 Accepting new patients

Locations

1208 US Highway 98
Daphne, AL 36526
Phone (251) 626-5377

8151 Whitesburg Dr SE
Huntsville, AL 35802
Phone (256) 882-9711

5235 Rangeline Service Rd S
#101
Mobile, AL 36619
Phone (251) 544-6449

Organizations & group practices 3

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1538187885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 US HIGHWAY 98",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365264254",
            "telephone_number": "251-626-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 US HIGHWAY 98",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365264254",
            "telephone_number": "251-626-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STODARD",
        "first_name": "MICHAEL",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "09655",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "MD34796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "730-13088",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00015240",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009965870",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daphne, AL

Sources for this page

Verify at the official NPI Registry.