Active NPI
Anthony J Stock, M.D.
- Specialist
- Gulfport, MS
National Provider Identifier
1669579124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MS13805
- Practice address
- 12231 Ashley Drive
Suite C
Gulfport, MS 39503-2775 - Phone
- (228) 831-9400
- Fax
- (228) 831-9600
- NPI assigned
- Sep 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MS13805 | MS | Primary |
Addresses
Primary practice location
12231 Ashley Drive
Suite C
Gulfport, MS 39503-2775
Mailing address
12231 Ashley Drive
Suite C
Gulfport, MS 39503-2775
Phone (228) 831-9400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2017 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MS13805 | MS | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Awakenings, PA | Past | 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.
-
- Community/Behavioral Health Agency
- Gulfport, MS
- NPI 1639395197
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669579124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12231 ASHLEY DRIVE",
"address_2": "SUITE C",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395032775",
"telephone_number": "228-831-9400",
"fax_number": "228-831-9600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12231 ASHLEY DRIVE",
"address_2": "SUITE C",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395032775",
"telephone_number": "228-831-9400",
"fax_number": "228-831-9600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOCK",
"first_name": "ANTHONY",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MS",
"license": "MS13805",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gulfport, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.