Individual provider Active NPI

Beverly J Stickles, M.D.

  • Anesthesiology Physician
  • Huntsville, AL
National Provider Identifier
1679555940
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
160790 Issued in MA
Practice address
721 Madison St SE
Huntsville, AL 35801-4408
Phone
(256) 880-6711
Fax
(256) 880-6712
NPI assigned
Nov 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 160790 MA Primary

Addresses

Primary practice location

721 Madison St SE
Huntsville, AL 35801-4408

Mailing address

PO Box 288
Huntsville, AL 35804-0288
Phone (256) 880-6711

Other identifiers 7

IdentifierTypeStateIssuer
2000005OtherMAUNITED HEALTHCARE
2040590MedicaidMA
613824OtherMAHARVARD PILGRIM HEALTHCAR
5586023OtherMAAETNA
469828OtherMATUFTS HEALTHCARE
J27289STOtherMABLUE CROSS BLUE SHIELD
82971OtherMAAETNA US HEALTHCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
160790MAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metrowest Anesthesiology, Inc. Anesthesiology PastSince Nov 14, 1996 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.

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206489600000",
    "number": "1679555940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 288",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358040288",
            "telephone_number": "256-880-6711",
            "fax_number": "256-880-6712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 MADISON ST SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014408",
            "telephone_number": "256-880-6711",
            "fax_number": "256-880-6712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STICKLES",
        "first_name": "BEVERLY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-14",
        "last_updated": "2008-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "160790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2000005",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2040590",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCAR",
            "identifier": "613824",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5586023",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTHCARE",
            "identifier": "469828",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "J27289ST",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "82971",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; 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.