Individual provider Active NPI

Stephen G Fedec, DO

  • Cardiovascular Disease Physician
  • Jacksonville, FL
National Provider Identifier
1629048632
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
OS9424 Issued in FL
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

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
832460MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA, SC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20090616000480 FL Practitioner - Cardiovascular Disease (Cardiology) 5395725436 Reassigns benefits to 1 organization
I20180102000681 GA Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 5395725436 Reassigns benefits to 1 organization
I20201022001172 SC Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Interventional Cardiology 5395725436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Interventional Cardiology
Education
Philadelphia College of Osteopathic Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beaufort County Memorial HospitalGroup PAC ID 7810809365, 197 clinicians
Baptist Cardiology, Inc.Group PAC ID 2466614581, 98 clinicians

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 Hospital, Beaufort, SC, CCN 420067
  • Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
83246SCMDSchool Registered Nurse
30762GAMDCardiovascular Disease Physician
25MB0593880NJMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beaufort County Memorial Hospital CurrentSince Sep 15, 2020 Accepting new patients
Phoebe Physician Group, Inc CurrentSince Mar 1, 2020 Accepting new patients
Baptist Cardiology, Inc. Cardiovascular Disease CurrentSince Dec 1, 2025 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

  • Direct secure messaging: 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.

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": "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

Verify at the official NPI Registry.