DR. GREGORY L STIDHAM


Address: 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132-2113
Phone: 9014482300

DR. GREGORY L STIDHAM (NPI# 1366409666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1366409666
Entity Type Individual
Full Name DR. GREGORY L STIDHAM
Credential MD
Practice Address 1910 Nonconnah Blvd
Suite 120
Memphis
TN 38132-2113
Mailing Address 66 N Pauline St
Suite 206
Memphis
TN 38105-5105
Practice Telephone 9014482300
Practice Fax Number 9014486657
Mailing Telephone 9014487642
Mailing Fax Number 9014488015
Enumeration Date 2006-04-28
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor X

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2080P0203X Pediatrics
Specialization: Pediatric Critical Care Medicine
12680 TN Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
TN 3180615 05

Other Providers GREGORY STIDHAM

NPI Name Taxonomy Address Enumeration
1487627378 Gregory Stidham Family Medicine 1107a Brookdale St, Martinsville, VA 24112-4501 2006-02-10
1831183219 Gregory P Stidham Family Medicine 110 23rd St Nw, Fayette, AL 35555-1001 2005-08-31

Office Location

Street Address 1910 NONCONNAH BLVD
SUITE 120
City MEMPHIS
State TN
Zip Code 38132-2113

Providers in the same location

NPI Name Taxonomy Address Enumeration
1417933276 Cynthia Denise Cross Emergency Medicine 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132-2113 2005-12-22
1265719496 Tamara Devon Jones Social Worker 1910 Nonconnah Blvd, Suite #100, Memphis, TN 38132-2113 2011-11-16
1417244765 Compass Laboratory Services LLC Clinical Medical Laboratory 1910 Nonconnah Blvd, 108, Memphis, TN 38132-2113 2011-07-07
1508090986 Oana Maria Hendea Audiologist 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132-2113 2009-05-13
1649429119 Dawna J. Willis Nurse Practitioner 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132-2113 2008-09-09
1538315304 Samir Hasmukh Shah Pediatrics 1910 Nonconnah Blvd, Ste 120, Memphis, TN 38132-2113 2008-08-13
1710163373 Martha Katheryn Ballard Nurse Practitioner 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132-2113 2008-01-14
1861673816 Keith A. Collins Nurse Anesthetist, Certified Registered 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132-2113 2007-11-19
1851510978 Mindy A Mullins Nurse Anesthetist, Certified Registered 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132-2113 2007-04-25
1275629396 Sabrina Burns Kuster Pediatrics 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132-2113 2006-10-05
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1386163707 Casey Provo Dietitian, Registered 1689 Nonconnah Blvd., Memphis, TN 38132 2017-09-18
1164802195 Cynthia Luaune Poole Social Worker 2606 Corporate Dr, Memphis, TN 38132 2015-06-04
1033375753 Concentra Health Services, Inc. Clinic/Center 2831 Airways Blvd., Bldg. A, Suite 102, Memphis, TN 38132 2008-08-01
1063406676 The Synergy Foundation, Inc. Substance Abuse Rehabilitation Facility 2305 Airport Interchange Avenue, Memphis, TN 38132 2005-09-09
1932488129 Occupational Health Centers of The Southwest Pa Clinic/Center 2831 Airways Blvd, Bldg A, Ste 102, Memphis, TN 38132 2011-08-05
1699181461 Stacy Triplett Counselor 2305 Airport Interchange Ave, Memphis, TN 38132-1002 2014-07-01
1174852164 Delois Roberson Dentist 2781 Airways Blvd, Memphis, TN 38132-1104 2009-12-22
1801380985 Javier Jackson Physical Therapist 2781 Airways Blvd, Memphis, TN 38132-1104 2018-06-21
1326499252 Joshua Mock Physical Therapy Assistant 2781 Airways Blvd, Memphis, TN 38132-1104 2016-06-22
1295112720 Michelle Frulla Physical Therapy Assistant 2781 Airways Blvd, Memphis, TN 38132-1104 2015-05-05
Find all providers in zip 38132

Taxonomy Information

Taxonomy Code 2080P0203X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Pediatric Critical Care Medicine

Taxonomy Definition

A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics)

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1295266906 Ashlee Christmas Pediatrics 920 Madison Avenue Suite 447, Memphis, TN 38163-3818 2017-03-23
1477893121 Maria Del Pilar Anton Martin Pediatrics 51 N Dunlap St Fl 2, Memphis, TN 38105 2013-02-17
1053670273 Shantaveer Gangu Pediatrics 848 Adams Ave, Memphis, TN 38103-2816 2012-05-08
1568729747 Laurel Jeanette Metzler Pediatrics 848 Adams Ave, Memphis, TN 38103-2816 2012-04-12
1689930653 Sheridan Children's Healthcare Services of Tennessee, PC Pediatrics 6225 Humphreys Blvd, Memphis, TN 38120-2373 2012-04-04
1629367909 Nicholas Paul Morin Pediatrics 848 Adams Ave, Memphis, TN 38103 2011-04-07
1639494040 Asya Agulnik Pediatrics 262 Danny Thomas Pl, Memphis, TN 38105-3678 2010-03-30
1538315304 Samir Hasmukh Shah Pediatrics 1910 Nonconnah Blvd, Ste 120, Memphis, TN 38132-2113 2008-08-13
1265651830 Saad Ghafoor Pediatrics 262 Danny Thomas Pl, Memphis, TN 38105-3678 2007-04-24
1871673202 Nadeem I Shafi Pediatrics 848 Adams Ave, Memphis, TN 38103-2816 2006-10-17
Find all providers in MEMPHIS

Competitor

Search similar providers

City MEMPHIS
Zip Code 38132

Improve Information

Please comment or provide details below to improve the information on DR. GREGORY L STIDHAM.

Dataset Information

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.

Trending Searches