ALEX LEE STIDHAM (PA-C) – Physician Assistant, NPI 1023998655

ALEX LEE STIDHAM (PA-C) is a healthcare provider. based in Speedwell, Tennessee. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 6765 (TN). The NPI Number for ALEX LEE STIDHAM (PA-C) is 1023998655

Main info

Male
Sole Proprietor
1 Year Of Experience
Accepts Medicare Assignment
Name
ALEX LEE STIDHAM (PA-C)
NPI
1023998655
Phone
(423) 489-6257
Address
619 BLUE SPRINGS RD
Enumeration Date
4 September 2025
Last Update Date
2 February 2026

Doctor Profile

Medical School Name
LINCOLN MEMORIAL UNIVERSITY MEDICAL DEPARTMENT
Secondary Phone
4233747775
Graduation Year
2025 (1 year ago)
PAC ID
1557841095
Group Practice PAC ID
1951721802
Professional Enrollment ID
I20260213004304
Address ID
TN377574850JA2702XPIKE300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

3,118 PHYSICIAN ASSISTANT in TN

Provider Addresses for ALEX LEE STIDHAM (PA-C)

  • 619 BLUE SPRINGS RD

    SPEEDWELL, TN 378701847

    Phone: (423) 489-6257

    Type: Mailing

  • 120 Tanner Pl

    Clinton, TN 377166684

    Phone: (865) 855-3500

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2026-02-13

PECOS data refreshed: 2026-05-27

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
I20260213004304IPhysician AssistantTNTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 37870)

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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: 1951721802View full group profile
NameSpecialtyState
Nurse PractitionerCA
Nurse PractitionerAR
Nurse PractitionerAR
Physician AssistantTN
Nurse PractitionerAR
Nurse PractitionerAR
Nurse PractitionerAR
Physician AssistantKY
Nurse PractitionerTX
Nurse PractitionerTN

Reviews

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Frequently asked questions

Does ALEX LEE STIDHAM (PA-C) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — ALEX LEE STIDHAM (PA-C) uses 1023998655.
Is ALEX LEE STIDHAM (PA-C) still practicing?
ALEX LEE STIDHAM (PA-C) is currently listed as active in the public NPI registry.
What taxonomy line describes ALEX LEE STIDHAM (PA-C)?
For research purposes, treat ALEX LEE STIDHAM (PA-C) as Physician Assistant in this dataset. Clinical services aligned with this taxonomy classification.
Where is ALEX LEE STIDHAM (PA-C) based?
ALEX LEE STIDHAM (PA-C) is tied to Speedwell, Tennessee in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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