Individual provider Active NPI

Stephen H Armistead, MD

  • Adult Medicine Physician
  • Panama City, FL
National Provider Identifier
1619932944
Registry record updated Apr 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
ME92110 Issued in FL
Practice address
2420 Jenks Ave
Unit 5
Panama City, FL 32405-4909
Phone
(850) 763-3635
Fax
(850) 763-4448
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X ME92110 FL Primary

Addresses

Primary practice location

2420 Jenks Ave
Unit 5
Panama City, FL 32405-4909

Mailing address

PO Box 97
Lynn Haven, FL 32444-0097
Phone (850) 763-3635

Other identifiers 2

IdentifierTypeStateIssuer
272152000MedicaidFL
64058OtherFLBCBS OF FLORIDA

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
ME92110FLMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Family Medicine PA PastSince Feb 14, 2005 Accepting new patients

Organizations & group practices 1

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397692800000",
    "number": "1619932944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 97",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324440097",
            "telephone_number": "850-763-3635",
            "fax_number": "850-763-4448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 JENKS AVE",
            "address_2": "UNIT 5",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054909",
            "telephone_number": "850-763-3635",
            "fax_number": "850-763-4448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARMISTEAD",
        "first_name": "STEPHEN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2014-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "ME92110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272152000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "64058",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2014; 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.