Stidham Medical, LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

STIDHAM MEDICAL, LLC

Practice address

1890 Al Highway 157 Ste 220
Cullman, AL 35058-0689

Phone

(256) 739-1233

Fax

(256) 734-5129

NPI assigned

May 23, 2006

Organization subpart

No

Name

Dr. Jeremy Stidham

Title

President/Owner

Phone

(256) 739-1233

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Donald D Dyer

  • Sonography Radiologic Technologist
  • Vinemont, AL
  • NPI 1972819787
  NPD (past)

• Pinnacle Mobile Imaging, LLC Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 27, 2015.

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427414400000",
    "number": "1679528186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 AL HIGHWAY 157 STE 220",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350580689",
            "telephone_number": "256-739-1233",
            "fax_number": "256-734-5129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 AL HIGHWAY 157 STE 220",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350580689",
            "telephone_number": "256-739-1233",
            "fax_number": "256-734-5129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STIDHAM MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2015-03-27",
        "status": "A",
        "authorized_official_last_name": "STIDHAM",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "256-739-1233",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000032914",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pinnacle Mobile Imaging, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sara J Stephens, LPC
• Ludmilla V. Stevens, MSW,LCSW,PIP
• Mandy Stewart
• Marsena Mayfield Stewart, CRNP
• Philip Preston Stewart, D.O.
• Jeremy Verbon Stidham, M.D.
• Katherine Weldon Stidham, D.M.D.
• Clark Still, LPC
• Lauren McGuire Stone, CRNP
• Bethany Lynn Story, CRNA

• All providers in Cullman, AL
• Physiological Laboratory in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.