Gregory P Stidham, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

00021977 Issued in AL

Practice address

110 23Rd St NW
Fayette, AL 35555-1001

Phone

(205) 932-3891

Fax

(205) 932-3996

NPI assigned

Aug 31, 2005

Last updated

Feb 18, 2013By the provider in NPPES

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

Other identifiers 2

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

Specialty

Family PracticeAlso: Emergency Medicine

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Garry W Magouirk MDPCGroup PAC ID 8628096047, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fayette Medical Center Homecare Home health agency, Fayette, AL, CCN 017088
• Amedisys Home Health of Tuscaloosa Home health agency, Northport, AL, CCN 017300
• Enhabit Home Health Home health agency, Vernon, AL, CCN 017079
• Fayette Medical Center Hospital, Fayette, AL, CCN 010045

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gregory.stidham@78233744637956.direct.elationemr.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Garry W Magouirk MDPC

  • Family Medicine Physician
  • Fayette, AL
  • NPI 1922029263
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amedisys Alabama, LLC

  dba Amedisys Home Health of Tuscaloosa

  • Home Health Agency
  • Northport, AL
  • NPI 1093773319
  Care Compare affiliation
• Caresouth HHA Holdings of Valley, LLC

  dba Enhabit Home Health

  • Home Health Agency
  • Vernon, AL
  • NPI 1548787401
  Care Compare affiliation
• Fayette Medical Center

  • General Acute Care Hospital
  • Fayette, AL
  • NPI 1851323836
  Care Compare affiliation
• Fayette Medical Center Homecare, LLC

  dba Adoration Home Health

  • Home Health Agency
  • Fayette, AL
  • NPI 1821241613
  Care Compare affiliation

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361145600000",
    "number": "1831183219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 23RD ST NW",
            "city": "FAYETTE",
            "state": "AL",
            "postal_code": "355551001",
            "telephone_number": "205-932-3891",
            "fax_number": "205-932-3996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 23RD ST NW",
            "city": "FAYETTE",
            "state": "AL",
            "postal_code": "355551001",
            "telephone_number": "205-932-3891",
            "fax_number": "205-932-3996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIDHAM",
        "first_name": "GREGORY",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2013-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "00021977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009928080",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "630936460",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Relias Emergency Medicine Specialists of Fayette, LLC
• Relias Hospitalist Medicine Specialists of Fayette, LLC
• SCPG Alabama LLC (Express Rx of Fayette)
• State of Alabama
• State of Alabama Department of Public Health (Fayette County Health Dept Flu-Pneu)
• Kathryn Stowe
• Sunshine Clinic
• Temple Emergency Group LLC
• The Arc of Fayette/Lamar/Marengo Counties Inc
• The Language Lab

• Family Medicine Physician in Fayette, AL
• Providers in Fayette, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.