NPIMap

Individual provider Active NPI

Stephen D Harrison, M.D.

  • Family Medicine Physician
  • Fulton, IL
National Provider Identifier
1649221508
Registry record updated Mar 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
24271 Issued in IA
Practice address
1705 16TH Ave
Fulton, IL 61252-9708
Phone
(815) 589-2121
Fax
(815) 589-4468
NPI assigned
May 15, 2006
Last updated
Mar 15, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 24271 IA Primary

Addresses

Primary practice location

1705 16TH Ave
Fulton, IL 61252-9708

Mailing address

915 13TH Ave N
Clinton, IA 52732-5067
Phone (563) 243-2511

Other identifiers 9

IdentifierTypeStateIssuer
036070350MedicaidIL
09822109OtherILBLUE CROSS BLUE SHIELD
27100OtherIOWA HEALTH SOLUTIOS
0219477MedicaidIA
20317OtherIAWELLMARK BC/BS
29840094OtherILLINOIS BCBS
IA0118OtherJOHN DEERE HEALTH
18999OtherMIDLANDS CHOICE
018854OtherHEALTH ALLIANCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100324000631 IL Practitioner - Family Practice 7113967761 Reassigns benefits to 4 organizations
Receives reassigned benefits from 1 practitioner
Practice locations: Morrison, IL; Prophetstown, IL; Savanna, IL
I20100429001131 IA Practitioner - Family Practice 7113967761 Reassigns benefits to 4 organizations
Receives reassigned benefits from 1 practitioner
Practice locations: Camanche, IA; Clinton, IA; De Witt, IA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ahmed Elahmady PCGroup PAC ID 8123930385, 3 clinicians
Provider Partners Care Management LPGroup PAC ID 9335379270, 31 clinicians

Practice addresses (Care Compare)

2745 Lincoln Way
Quality Care Clinic
Clinton, IA 52732-7201
Phone (563) 242-3208

4655 W Chase Ave
Lincolnwood, IL 60712-1605
Phone (847) 780-1000

767 30TH St
Rock Island, IL 61201-1945
Phone (561) 315-5037

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
23.79 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
79.31

Merit-based Incentive Payment System (MIPS)

Final score
88.8 of 100Reported as apm
Quality
82.54
Promoting interoperability
89.05
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24271IAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Provider Partners Care Management LP Family Medicine CurrentSince Dec 17, 2024 Accepting new patients
Mercy Specialty Clinic Family Medicine CurrentSince Jul 1, 2019 Accepting new patients
City Medical Partners PA CurrentSince May 11, 2016 Accepting new patients
Mercy Specialty Clinic CurrentSince Jul 1, 2019 Accepting new patients
St Anthonys Rehabilitation and Nursing Center LLC CurrentSince Jul 1, 2025 Accepting new patients
Ahmed Elahmady PC CurrentSince Sep 1, 2025 Accepting new patients
Sigma Haggerty Medical PA CurrentSince May 11, 2016 Accepting new patients
Cornerstone Wellness Center LLC Family Medicine CurrentSince Aug 31, 2011 Accepting new patients
Ahmed Elahmady PC CurrentSince Sep 1, 2025 Accepting new patients
Camanche 1, LLC Dba Park Vista Retirement Living-Camanche Past Accepting new patients
Excelsior Ranch PastSince May 25, 2025 Accepting new patients

Locations

1523 S Bluff Blvd
Clinton, IA 52732
Phone (563) 243-6054

2745 Lincoln Way
Clinton, IA 52732
Phone (563) 242-3208

2745 Lincoln Way
#30
Clinton, IA 52732

600 14th Ave N
Clinton, IA 52732
Phone (563) 244-3680

801 28th Ave N
Clinton, IA 52732
Phone (563) 243-6600

849 13th Ave N
Clinton, IA 52732
Phone (563) 242-1521

915 13th Ave N
Clinton, IA 52732
Phone (319) 243-2511

1301 Maynard Way
De Witt, IA 52742
Phone (563) 221-7110

50 N Jane Dr
Elgin, IL 60123
Phone (815) 844-2610

379 Fountains Pkwy
Fairview Hts, IL 62208
Phone (618) 235-6600

1705 16th Ave
Fulton, IL 61252
Phone (815) 589-2121

817 17th St
Fulton, IL 61252
Phone (815) 589-3411

400 S Station Rd
Glen Carbon, IL 62034
Phone (618) 288-5014

4655 W Chase Ave
Lincolnwood, IL 60712
Phone 8472623800202

201 S 10th St
Mascoutah, IL 62258
Phone (618) 566-8000

303 N Jackson St
Morrison, IL 61270
Phone (815) 772-4003

500 N Jackson St
Morrison, IL 61270
Phone (815) 772-7228

635 E Lincolnway
Morrison, IL 61270
Phone (815) 772-7274

310 Mosher Dr
Prophetstown, IL 61277
Phone (815) 537-2226

415 A St
Prophetstown, IL 61277
Phone (815) 337-5358

767 30th St
Rock Island, IL 61201
Phone (309) 788-7631

8820 Columbia 100 Pkwy
Ste 430
Columbia, MD 21045
Phone (317) 432-0682

21333 Haggerty Rd
Ste 150
Novi, MI 48375
Phone (248) 662-0250

Interoperability endpoints

  • Direct secure messaging: sharrison@gm-mi.direct.office.nextgen.com
  • Direct secure messaging: sharrison4172145@direct.trinity-health.org

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Resthave Home of Whiteside County IllinoisMorrison, IL, CCN 146177 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 1, 2015
Mar 31, 2025
Eagle Point Nursing and RehabilitationClinton, IA, CCN 165218 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2024
Jan 1, 2024
Highlight Healthcare of MorrisonMorrison, IL, CCN 146084 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Dec 1, 2024
Dec 1, 2024

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Organizations & group practices 11

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 12

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363305600000",
    "number": "1649221508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 13TH AVE N",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527325067",
            "telephone_number": "563-243-2511",
            "fax_number": "563-243-0817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 16TH AVE",
            "city": "FULTON",
            "state": "IL",
            "postal_code": "612529708",
            "telephone_number": "815-589-2121",
            "fax_number": "815-589-4468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "STEPHEN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2013-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "24271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036070350",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09822109",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA HEALTH SOLUTIOS",
            "identifier": "27100",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0219477",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BC/BS",
            "identifier": "20317",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS BCBS",
            "identifier": "29840094",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE HEALTH",
            "identifier": "IA0118",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "18999",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "018854",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulton, IL

Sources for this page

Verify at the official NPI Registry.