Active NPI
Stephen G Fedec, DO
- Cardiovascular Disease Physician
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- OS9424
- Practice address
- 11851 Stillwood Pines Blvd
Suite 203
Jacksonville, FL 32224-4435 - Phone
- (904) 376-4820
- Fax
- (904) 618-2150
- NPI assigned
- Jan 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | OS9424 | FL | Primary |
| Cardiovascular Disease Physician | 207RC0000X | 25MB0593880 | NJ | |
| Interventional Cardiology Physician | 207RI0011X | OS9424 | FL | |
| Cardiovascular Disease Physician | 207RC0000X | 30762 | GA | |
| Cardiovascular Disease Physician | 207RC0000X | 83246 | SC |
Addresses
Primary practice location
11851 Stillwood Pines Blvd
Suite 203
Jacksonville, FL 32224-4435
Mailing address
PO Box 746652
Atlanta, GA 30374-6652
Phone (904) 202-2092
Other practice location 1
1320 Roberts Dr Ste 101
Jacksonville Beach, FL 32250-3253
Phone (904) 241-7147
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 832460 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, GA, SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Philadelphia College of Osteopathic Medicine, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
300 Midtown Dr
Beaufort, SC 29906-5200
Phone (843) 770-0404
400 Colonnade Dr
Suite 230
Ponte Vedra, FL 32081-6236
Phone (904) 720-0599
955 Ribaut Rd
Beaufort, SC 29902-5441
Phone (843) 522-5983
989 Ribaut Rd
Beaufort, SC 29902-5472
Hospital & facility affiliations
- Beaufort County Memorial Hospital
- Baptist Medical Center Beaches
- Baptist Health Medical Center - Jacksonville
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 83246 | SC | MD | School Registered Nurse |
| 30762 | GA | MD | Cardiovascular Disease Physician |
| 25MB0593880 | NJ | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beaufort County Memorial Hospital | Current | Accepting new patients | |
| Phoebe Physician Group, Inc | Current | Accepting new patients | |
| Baptist Cardiology, Inc. | Cardiovascular Disease | Current | Accepting new patients |
| Beaufort County Memorial Hospital | Past | Accepting new patients | |
| Baptist Cardiology Inc | Cardiovascular Disease | Past | Accepting new patients |
Locations
836 Prudential Dr
Ste 1700
Jacksonville, FL 32207
Phone (904) 398-0125
1320 Roberts Dr
Ste 101
Jacksonville Beach, FL 32250
Phone (904) 241-7147
400 Colonnade Dr
Rm D2
Ponte Vedra, FL 32081
400 Colonnade Dr
Ste 230
Ponte Vedra Beach, FL 32081
Phone (904) 202-1795
417 W 3rd Ave
Albany, GA 31701
Phone (229) 317-2207
500 W 3rd Ave
Ste 101
Albany, GA 31701
Phone (229) 312-5802
2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802
151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900
989 Ribaut Rd
Ste 103
Beaufort, SC 29902
Phone (843) 522-5351
300 Midtown Dr
Beaufort, SC 29906
Phone (843) 379-7746
955 Ribaut Rd
#C
Beaufort, SC 29902
955 Ribaut Rd
Beaufort, SC 29902
Phone (803) 522-5200
122 Okatie Center Blvd N
Ste 300
Okatie, SC 29909
Phone (843) 707-8040
1680 Ribaut Rd
Port Royal, SC 29935
Phone (843) 522-7600
Interoperability endpoints
- sfedec344514@baptisthealthsystemjacksonville.direct-ci.com
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 and National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Jacksonville, FL
- NPI 1760751598
-
- Emergency Medicine Physician
- Beaufort, SC
- NPI 1871335018
-
- Clinic/Center
- Albany, GA
- NPI 1487899464
-
- General Practice Physician
- Beaufort, SC
- NPI 1336180165
-
- Cardiovascular Disease Physician
- Jacksonville, FL
- NPI 1013854140
-
- Obstetrics & Gynecology Physician
- Beaufort, SC
- NPI 1235552746
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jacksonville Beach, FL
- NPI 1821155912
-
- General Acute Care Hospital
- Jacksonville, FL
- NPI 1578620449
-
- General Acute Care Hospital
- Beaufort, SC
- NPI 1366436073
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785801600000",
"number": "1629048632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 746652",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303746652",
"telephone_number": "904-202-2092",
"fax_number": "904-376-4075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11851 STILLWOOD PINES BLVD",
"address_2": "SUITE 203",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322244435",
"telephone_number": "904-376-4820",
"fax_number": "904-618-2150"
}
],
"practiceLocations": [
{
"address_1": "1320 Roberts Dr Ste 101",
"address_purpose": "LOCATION",
"city": "Jacksonville Beach",
"state": "FL",
"postal_code": "322503253",
"country_code": "US",
"telephone_number": "904-241-7147",
"fax_number": "904-376-2313",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FEDEC",
"first_name": "STEPHEN",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-23",
"last_updated": "2026-08-04",
"certification_date": "2026-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "FL",
"license": "OS9424",
"primary": true
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "NJ",
"license": "25MB0593880",
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "FL",
"license": "OS9424",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "GA",
"license": "30762",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "SC",
"license": "83246",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "832460",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.