NPIMap

Individual provider Active NPI

Phillip Edward Stiles, PA-C

  • Physician Assistant
  • Freeport, IL
National Provider Identifier
1972528313
Registry record updated Nov 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
422 Issued in MT
Practice address
1010 Fairway Dr
Freeport, IL 61032-6600
Phone
(815) 599-7831
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 422 MT Primary

Addresses

Primary practice location

1010 Fairway Dr
Freeport, IL 61032-6600

Mailing address

421 W Exchange St
PO Box 268
Freeport, IL 61032-4008
Phone (815) 599-7958

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041202000147 MN Practitioner - Physician Assistant 4385600345 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Althing LLCGroup PAC ID 9537538160, 4 clinicians
Sanford Health of Northern MinnesotaGroup PAC ID 5597725168, 349 clinicians

Practice addresses (Care Compare)

1600 8TH Ave NW
Austin, MN 55912-1400
Phone (888) 423-7247

1611 Anne St NW
Bemidji, MN 56601-5114
Phone (218) 333-5000

Hospital & facility affiliations

  • Sanford Bemidji Medical Center Hospital, Bemidji, MN, CCN 240100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
143SDMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health of Northern Minnesota CurrentSince Dec 19, 2022 Accepting new patients
Rural Health Care, Inc. CurrentSince Sep 1, 2022 Accepting new patients
Fairview Health Services CurrentSince Feb 14, 2016 Accepting new patients
Rural Health Care, Inc CurrentSince Sep 1, 2022 Accepting new patients
Unity Family Healthcare CurrentSince May 11, 2020 Accepting new patients
Unity Family Healthcare CurrentSince May 11, 2020 Accepting new patients
Fairview Health Services CurrentSince Feb 14, 2016 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Fort Yates Indian Health Service Hospital Past Accepting new patients

Locations

7892 Solutions Ctr
Chicago, IL 60677

1611 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2020

815 2nd St SE
Little Falls, MN 56345
Phone (320) 632-5441

300 S Bruce St
Ste 100
Marshall, MN 56258

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1216 Ryans Rd
Ste 3
Worthington, MN 56187
Phone (507) 372-6522

Interoperability endpoints

  • Direct secure messaging: pstiles525924@direct.centracare.com
  • Direct secure messaging: phillip.stiles.1@23223.direct.athenahealth.com

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257897600000",
    "number": "1972528313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 W EXCHANGE ST",
            "address_2": "PO BOX 268",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610324008",
            "telephone_number": "815-599-7958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 FAIRWAY DR",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610326600",
            "telephone_number": "815-599-7831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILES",
        "first_name": "PHILLIP",
        "middle_name": "EDWARD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2009-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, IL

Sources for this page

Verify at the official NPI Registry.