Active NPI
Stephen V Goryl, MD
- Urology Physician
- Cookeville, TN
National Provider Identifier
1740273408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- MD10050
- Practice address
- 320 N Oak Ave
Cookeville, TN 38501-2440 - Phone
- (931) 528-5547
- Fax
- (931) 526-2699
- NPI assigned
- Aug 29, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | MD10050 | TN | Primary |
| Urology Physician | 208800000X | L266355 | MI |
Addresses
Primary practice location
320 N Oak Ave
Cookeville, TN 38501-2440
Mailing address
320 N Oak Ave
Cookeville, TN 38501-2440
Phone (931) 528-5547
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2004651 | Other | TN | BLUE CROSS BLUE SHEILD |
| 1940005 | Other | TN | UNITED HEALTHCARE |
| 3378641 | Medicaid | TN | |
| 2004651 | Other | TN | TENNCARE SELECT |
| 9644104 | Other | TN | CIGNA 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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L266355 | MI | MD | Urology Physician |
| MD10050 | TN | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196640000000",
"number": "1740273408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 N OAK AVE",
"city": "COOKEVILLE",
"state": "TN",
"postal_code": "385012440",
"telephone_number": "931-528-5547",
"fax_number": "931-526-2699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 N OAK AVE",
"city": "COOKEVILLE",
"state": "TN",
"postal_code": "385012440",
"telephone_number": "931-528-5547",
"fax_number": "931-526-2699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORYL",
"first_name": "STEPHEN",
"middle_name": "V",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-29",
"last_updated": "2007-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "TN",
"license": "MD10050",
"primary": true
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "MI",
"license": "L266355",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHEILD",
"identifier": "2004651",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "1940005",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3378641",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TENNCARE SELECT",
"identifier": "2004651",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTHCARE",
"identifier": "9644104",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cookeville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.