DR. TED JUSTIN STIDHAM (NPI# 1134428402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134428402 |
| Entity Type | Individual |
| Full Name | DR. TED JUSTIN STIDHAM |
| Credential | M.D. |
| Practice Address |
1611 27th St Fulton Building, Suite 101 Portsmouth OH 45662-6931 |
| Mailing Address |
1735 27th St Waller Building, Suite B06 Portsmouth OH 45662-2677 |
| Practice Telephone | 7403567337 |
| Practice Fax Number | 7403566304 |
| Mailing Telephone | 7403568681 |
| Mailing Fax Number | 7403537900 |
| Enumeration Date | 2011-03-25 |
| Last Update Date | 2014-07-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 35.120739 | OH | Allopathic & Osteopathic Physicians |
| Street Address |
1611 27TH ST FULTON BUILDING, SUITE 101 |
| City | PORTSMOUTH |
| State | OH |
| Zip Code | 45662-6931 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225420359 | Jeffrey R Hill Do Inc | Family Medicine | 1611 27th St, Fulton Building Suite 301, Portsmouth, OH 45662-6931 | 2015-02-26 |
| 1558779173 | Keri Kuhn | Nurse Practitioner | 1611 27th St, Suite 201, Fulton Building, Portsmouth, OH 45662-6931 | 2014-07-28 |
| 1124469416 | Amy J. Flinders | Nurse Practitioner | 1611 27th St, Braunlin Building, Suite101, Portsmouth, OH 45662-6931 | 2013-07-15 |
| 1750631156 | Elisa Nicole Gullion | Physician Assistant | 1611 27th St, Fulton Bldg, Ste 204, Portsmouth, OH 45662-6932 | 2012-09-12 |
| 1285917096 | Kari Lynn Ward | Nurse Practitioner | 1611 27th St, Fulton Bldg., Ste 201, Portsmouth, OH 45662-6931 | 2011-09-28 |
| 1487944542 | Mikell N Rase | Pediatrics | 1611 27th St, Fulton Building, Suite 101, Portsmouth, OH 45662-6931 | 2011-04-11 |
| 1356530018 | Primary Medical Specialists, Inc | Internal Medicine | 1611 27th St, Fulton Bldg. Suite 101, Portsmouth, OH 45662-6931 | 2007-10-18 |
| 1689861825 | Darren Adams, D.o. L.l.c | Obstetrics & Gynecology | 1611 27th St, Suite 302, Portsmouth, OH 45662-6931 | 2007-10-02 |
| 1134328594 | Samantha L Cook | Pediatrics | 1611 27th St, Fulton Building, Suite 101, Portsmouth, OH 45662-6931 | 2007-07-16 |
| 1154475135 | Yong D Song Md Inc | Obstetrics & Gynecology | 1611 27th St, Building J Suite 204, Portsmouth, OH 45662 | 2007-01-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528613346 | Stacia N Boyer | Nurse Practitioner | 1611 27th Street, Fulton Bldg Suite 101, Portsmouth, OH 45662 | 2019-08-08 |
| 1487210167 | Rose Speier | Registered Nurse | 920 Gallia Street, Portsmouth, OH 45662 | 2019-05-17 |
| 1083123491 | Megan Rhea | Case Manager/Care Coordinator | 901 Wahington St, Portsmouth, OH 45662 | 2017-09-28 |
| 1376061903 | Alanna Lee Reisinger | Physical Therapist | 522 Glenwood Ave., New Boston, OH 45662 | 2017-09-04 |
| 1871010967 | Nicole Lynne Johnson | Counselor | 800 Gallia Street Suite 600, Portsmouth, OH 45662 | 2017-08-29 |
| 1629595822 | William Zachary Nance | Counselor | 800 Gallia Street, Suite 600, Portsmouth, OH 45662 | 2017-08-28 |
| 1962929703 | Melissa Rodbell | Speech-Language Pathologist | 514 Union St., Portsmouth, OH 45662 | 2017-08-23 |
| 1346604626 | Todd Davis | Counselor | 2954 Walnut St., Portsmouth, OH 45662 | 2016-04-12 |
| 1083078406 | Gordon Sanders | Counselor | 2954 Walnut Street, Portsmouth, OH 45662 | 2016-04-12 |
| 1033573910 | Michael L Purdy | Nurse Practitioner | 1735 27th Street Waller Bldg Suite 302, Portsmouth, OH 45662 | 2016-04-07 |
| Find all providers in zip 45662 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134685050 | Tidewater Pediatrics, P.C. | Pediatrics | 301 Goode Way Ste 203, Portsmouth, VA 23704-2266 | 2019-02-15 |
| 1164683967 | Kathlyn Valleau Wilde | Pediatrics | 620 John Paul Jones Cir Dept Of, Portsmouth, VA 23708-2111 | 2008-06-24 |
| 1437235421 | Perla Jamias Soloria | Pediatrics | 3701 South St, Portsmouth, VA 23707-3121 | 2006-10-31 |
| 1265523310 | Portsmouth Pediatrics | Pediatrics | 1985 E Main Rd, Portsmouth, RI 02871-1225 | 2006-09-27 |
| 1508884503 | John R Radford | Pediatrics | 1611 27th St Ste 101, Portsmouth, OH 45662-6932 | 2006-07-17 |
| 1679529424 | Kevin Hodges | Pediatrics | 200 Griffin Rd, Suite 15, Portsmouth, NH 03801-7145 | 2006-05-25 |
| 1225089196 | Rick David Murphy | Pediatrics | 1405 11th St, Portsmouth, OH 45662 | 2006-05-15 |
| 1811956204 | 04gloria Villanueva De La Cruz | Pediatrics | 500 Rodman Ave, Portsmouth, VA 23707-3100 | 2006-03-22 |
| 1205800489 | Lilliam I. Ortiz | Pediatrics | 23030 State Route 73, Portsmouth, OH 45663-8861 | 2006-02-15 |
| 1528039328 | Caleb John Podraza | Pediatrics | Naval Medical Center Department of Pediatrics, 620 John Paul Jones Circle, Portsmouth, VA 23708 | 2006-01-30 |
| Find all providers in PORTSMOUTH | ||||
| City | PORTSMOUTH |
| Zip Code | 45662 |
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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.