NPIMap

Individual provider Active NPI

Stephen Stratford Phelan, DMD

  • Periodontics
  • Montgomery, AL
National Provider Identifier
1932195674
Registry record updated Aug 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
2873 Issued in AL
Practice address
1554 E Trinity Blvd
Montgomery, AL 36106-3609
Phone
(334) 277-2100
Fax
(334) 277-2101
NPI assigned
Sep 27, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 2873 AL Primary

Addresses

Primary practice location

1554 E Trinity Blvd
Montgomery, AL 36106-3609

Mailing address

1554 E Trinity Blvd
Montgomery, AL 36106-3609
Phone (334) 277-2100

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Stephen S Phelan DMD PA Past Accepting new patients
Trammell Periodontics LLC Past Accepting new patients

Organizations & group practices 2

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": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376956800000",
    "number": "1932195674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1554 E TRINITY BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361063609",
            "telephone_number": "334-277-2100",
            "fax_number": "334-277-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1554 E TRINITY BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361063609",
            "telephone_number": "334-277-2100",
            "fax_number": "334-277-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELAN",
        "first_name": "STEPHEN",
        "middle_name": "STRATFORD",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2013-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "AL",
            "license": "2873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; 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.