Michael Shane Stevenson, DMD, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

5063 Issued in AL

Practice address

1401 Stratford Rd SE
Decatur, AL 35601-6022

Phone

(256) 355-1242

Fax

(256) 355-1259

NPI assigned

Jun 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256083200000",
    "number": "1700822020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 STRATFORD RD SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356016022",
            "telephone_number": "256-355-1242",
            "fax_number": "256-355-1259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 STRATFORD RD SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356016022",
            "telephone_number": "256-355-1242",
            "fax_number": "256-355-1259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "MICHAEL",
        "middle_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "DMD, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2009-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AL",
            "license": "5063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen L. Watkins, DMD, LLC
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• Steven a. Leach,DMD,PC
• Steven C Chandler MD PC
• Latora S Stevenson
• Stewart Chiropractic Clinic LLC
• Takasha Latoya Renee Stewart-Hubbard, M.D.
• Chelsey Danielle Stewart, DO
• De'Andra Michelle Stewart, D.C.
• Morgan Suzanne Stinson, PHARMD

• Oral and Maxillofacial Surgery (Dentist) in Decatur, AL
• Providers in Decatur, AL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.