JEFFREY M. STIDAM (NPI# 1063545275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063545275 |
| Entity Type | Individual |
| Full Name | JEFFREY M. STIDAM |
| Credential | MD |
| Practice Address |
225 Abraham Flexner Way Suite 305 Louisville KY 40202-1882 |
| Mailing Address |
100 E Liberty St Ste 800 Louisville KY 40202-1428 |
| Practice Telephone | 5025854321 |
| Practice Fax Number | 5025666338 |
| Mailing Telephone | 5025854321 |
| Mailing Fax Number | 5025666338 |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2018-03-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
01063360A | IN | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
39017 | KY | Allopathic & Osteopathic Physicians |
| N | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
01063360A | IN | Allopathic & Osteopathic Physicians |
| Y | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
39017 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200856500 | 05 | |
| KY | 7100069260 | 05 |
| Street Address |
225 ABRAHAM FLEXNER WAY SUITE 305 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40202-1882 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922008747 | Michelle D. Palazzo | Plastic Surgery | 225 Abraham Flexner Way, Suite 700, Louisville, KY 40202-1846 | 2005-07-22 |
| 1427564004 | Shana Michelle Andres | Occupational Therapist | 225 Abraham Flexner Way, Louisville, KY 40202-1882 | 2017-12-19 |
| 1952810681 | Shiro Yoshida | Orthopaedic Surgery | 225 Abraham Flexner Way, Suite 850, Louisville, KY 40202 | 2017-09-26 |
| 1083139034 | Ezequiel Ernesto Zaidenberg | Orthopaedic Surgery | 225 Abraham Flexner Way, Suite 850, Louisville, KY 40202 | 2017-08-11 |
| 1982128658 | Uzair Ahmed Qazi | Plastic Surgery | 225 Abraham Flexner Way, Suite 850, Louisville, KY 40202 | 2017-08-03 |
| 1033650122 | Michelle Cardwell | Nurse Practitioner | 225 Abraham Flexner Way, Outpatient Care Center - Endoscopy Unit, Louisville, KY 40202-1882 | 2017-03-09 |
| 1053866087 | Donald Alexander Graham | Plastic Surgery | 225 Abraham Flexner Way, Suite 850, Louisville, KY 40202-1882 | 2016-08-19 |
| 1720445604 | Kiran Anderson | Student in an Organized Health Care Education/Training Program | 225 Abraham Flexner Way, Suite 850, Louisville, KY 40202 | 2016-01-22 |
| 1003281460 | Leah D Ashby | Nurse Practitioner | 225 Abraham Flexner Way, Suite 305, Louisville, KY 40202-1882 | 2015-12-09 |
| 1881068088 | Oleksandra Vyrva | Student in an Organized Health Care Education/Training Program | 225 Abraham Flexner Way, Louisville, KY 40220 | 2015-11-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972129682 | Garvit Chhabra | Student in an Organized Health Care Education/Training Program | 550, South Jackson Street, Acb, Third Floor, Louisville, KY 40202 | 2020-06-18 |
| 1396367009 | Richele Williams | Student in an Organized Health Care Education/Training Program | 201 Abraham Flexner Way Department of Family and Pediac, Suite 690, Louisville, KY 40202 | 2020-05-15 |
| 1942822028 | Ahmed Khaled Saleh | Student in an Organized Health Care Education/Training Program | 500 S Jackson St, Room 305, Louisville, KY 40202 | 2020-05-12 |
| 1457972952 | Mir Ali Raza Talpur | Student in an Organized Health Care Education/Training Program | 401 E Chestnut Street, Suite 600 University of Louisvi, Louisville, KY 40202 | 2020-05-06 |
| 1316575533 | Abigail Hatfield | Student in an Organized Health Care Education/Training Program | Internal Medicine Training Program, 550 South Jackson Street, Acb 3rd Floor, Louisville, KY 40202 | 2020-04-01 |
| 1851929210 | Madison Harmon | Student in an Organized Health Care Education/Training Program | Uofl Department of Emergency Medicine, 530 S. Jackson Street Room C1h17, Louisville, KY 40202 | 2020-03-31 |
| 1184252041 | Marianna Weaver | Student in an Organized Health Care Education/Training Program | 550 South Jackson Street, Acb 3rd Floor, University of Louisville, Louisville, KY 40202 | 2020-03-27 |
| 1700347341 | Charles Jake Sadle | Student in an Organized Health Care Education/Training Program | Office of Medical Education C/o Brittney Luckett, 571 S. Floyd St., Ste. 412, Louisville, KY 40202 | 2019-03-27 |
| 1437616794 | Paladina Health, LLC | Family Medicine | Paladina Health Humana East, 123 E Main Street, Louisville, KY 40202 | 2019-02-22 |
| 1205393568 | Paladina Health, LLC | Family Medicine | Paladina Health Humana West, 500 W Main Street, Louisville, KY 40202 | 2019-02-22 |
| Find all providers in zip 40202 | ||||
| Taxonomy Code | 207RC0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Clinical Cardiac Electrophysiology |
| A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285622779 | Cardiac Care Center of Louisville, Pllc | Internal Medicine | 100 Mallard Creek Rd, Suite 150, Louisville, KY 40207-4194 | 2005-10-10 |
| 1336144401 | Christopher Lars Johnsrude | Internal Medicine | 411 E Chestnut St # 5a, Louisville, KY 40202-1713 | 2005-06-16 |
| 1790941367 | Kelvin Cheukhang Lau | Internal Medicine | 601 S Floyd St, Suite 602, Louisville, KY 40202-1845 | 2008-08-04 |
| 1710181037 | Cardiac Care Center of Louisville | Internal Medicine | 720 W Hill St, Louisville, KY 40208-2216 | 2007-06-12 |
| 1689885782 | Medical Center Cardiologists, Psc | Internal Medicine | 400 Executive Park, Louisville, KY 40207-4204 | 2007-05-24 |
| 1760692107 | Cardiac Care Center of Louisville, Pllc | Internal Medicine | 225 Abraham Flexner Way, Suite 305, Louisville, KY 40202-1846 | 2007-05-23 |
| 1740490192 | Cardiac Care Center of Louisville, Pllc | Internal Medicine | 100 Mallard Creek Rd, Suite 390, Louisville, KY 40207-4194 | 2007-05-23 |
| 1043429871 | Medical Center Cardiologists, Psc | Internal Medicine | 100 Mallard Creek Rd, Suite 390, Louisville, KY 40207-4194 | 2007-05-21 |
| 1912947946 | Robert A Schwartz | Internal Medicine | 6420 Dutchmans Pkwy, Suite 200, Louisville, KY 40205-3372 | 2006-06-07 |
| 1225087612 | Rajdeep S. Gaitonde | Internal Medicine | 225 Abraham Flexner Way, Suite 305, Louisville, KY 40202-1882 | 2006-05-10 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40202 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.