JOHN STANBACK (MD) – Family Medicine Physician, NPI 1629034764

JOHN STANBACK (MD) is a healthcare provider. based in Columbus, Mississippi. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 13912 (MS). The NPI Number for JOHN STANBACK (MD) is 1629034764

Main info

Male
33 Years Of Experience
Accepts Medicare Assignment
Name
JOHN STANBACK (MD)
NPI
1629034764
Phone
(662) 244-1705
Address
2400 5th St N
Enumeration Date
26 April 2006
Last Update Date
14 May 2025

Doctor Profile

Medical School Name
UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Secondary Phone
6622409999
Graduation Year
1993 (33 years ago)
PAC ID
7113119439
Group Practice PAC ID
5193610228
Professional Enrollment ID
I20101005000933
Address ID
MS397018408CO3700XRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

941 FAMILY PRACTICE in MS

Provider Addresses for JOHN STANBACK (MD)

  • 2400 5th St N

    Columbus, MS 397052000

    Phone: (662) 244-1705

    Fax: (662) 244-1713

    Type: Location

  • 2104 5th St N

    Columbus, MS 397052236

    Phone: (662) 244-1705

    Fax: (662) 244-1713

    Type: Location

  • 2600 5TH ST N

    COLUMBUS, MS 397052010

    Phone: (662) 244-2960

    Fax: (662) 244-2964

    Type: Location

  • 350 N HUMPHREYS BLVD

    MEMPHIS, TN 381202177

    Phone: (901) 226-4003

    Fax: (901) 227-8591

    Type: Mailing

  • N, Montgomery Court, Buckeye Village, Columbus, Sharon, Franklin, Ohio, 43210, United States

    COLUMBUS, MS 397052917

    Phone: (662) 328-9702

    Fax: (662) 328-0954

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 61 Open Payments records for all available years, with a total value of $988.

Total Amount is formed as General ($988) + Research ($0) + Ownership ($0) = $988.

Last reported payment date: 2024-06-06 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($218).

Total Amount

$988

General + Research + Ownership

Payments

61

Total payment records

General Amount

$988

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-06

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-10-05

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20101005000933IFamily PracticeMSTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes1,543613$0
36415Insertion of needle into vein for collection of blood sample1,097595$0
85027Complete blood cell count (red cells, white blood cell, platelets), automated test935568$0
80053Blood test, comprehensive group of blood chemicals907568$0
80061Blood test, lipids (cholesterol and triglycerides)767536$0
View full utilization report →

Insurance plans in this area (ZIP 39705)

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Provider's Procedures

JOHN STANBACK (MD) performs procedures in FAMILY PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEMS20610Aspiration and/or injection of large joint or joint capsule11685

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5193610228View full group profile
NameSpecialtyState
Osteopathic Manipulative MedicineNY
N E U R O L O G YCT
Nurse PractitionerGA
Nurse PractitionerMS
Internal MedicineAR
Internal MedicineGA
Nurse PractitionerTN
Internal MedicineTN
P S Y C H I A T R YOH
Nurse PractitionerMS

Reviews

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Frequently asked questions

Is JOHN STANBACK (MD) listed with a National Provider Identifier?
Yes — JOHN STANBACK (MD) has NPI 1629034764 on file in the registry.
Is JOHN STANBACK (MD) shown as active in public data?
Registry records indicate JOHN STANBACK (MD) maintains an active NPI.
What area of care is associated with JOHN STANBACK (MD)?
JOHN STANBACK (MD)'s record emphasizes Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where in Mississippi is JOHN STANBACK (MD) registered?
Use Columbus, Mississippi as the headline location for JOHN STANBACK (MD) here.
When was this NPI issued?
Enumeration for JOHN STANBACK (MD) is noted as April 26, 2006 where the registry provides it.

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