Individual provider Active NPI

Frank Durham Stegall, MD

  • Cardiovascular Disease Physician
  • Rome, GA
National Provider Identifier
1669537734
Registry record updated Aug 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
019107 Issued in GA
Practice address
504 Redmond Rd NW
Rome, GA 30165-1416
Phone
(706) 235-3855
Fax
(706) 290-2382
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 019107 GA Primary
Interventional Cardiology Physician 207RI0011X 019107 GA

Addresses

Primary practice location

504 Redmond Rd NW
Rome, GA 30165-1416

Mailing address

1825 Martha Berry Blvd NW
Rome, GA 30165-1625
Phone (706) 295-5331

Other identifiers 1

IdentifierTypeStateIssuer
000138256AMedicaidGA

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
I20170228000087 AL Order and Referring Only - Vascular SurgeryPractitioner - Vascular Surgery 3173546793

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
019107GAMDInterventional Cardiology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280707200000",
    "number": "1669537734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 MARTHA BERRY BLVD NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651625",
            "telephone_number": "706-295-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 REDMOND RD NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651416",
            "telephone_number": "706-235-3855",
            "fax_number": "706-290-2382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEGALL",
        "first_name": "FRANK",
        "middle_name": "DURHAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2010-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "019107",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "GA",
            "license": "019107",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000138256A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.