Active NPI
John Stansbury, MD
- Dermatology Physician
- Saint Paul, MN
National Provider Identifier
1003834698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 20150
- Practice address
- 1020 Bandana Blvd W
Saint Paul, MN 55108-5107 - Phone
- (651) 641-7000
- Fax
- (651) 641-7166
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 20150 | MN | Primary |
Addresses
Primary practice location
1020 Bandana Blvd W
Saint Paul, MN 55108-5107
Mailing address
1021 Bandana Blvd E
Suite 200
Saint Paul, MN 55108-5113
Phone (651) 642-2700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20150 | MN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003834698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1021 BANDANA BLVD E",
"address_2": "SUITE 200",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551085113",
"telephone_number": "651-642-2700",
"fax_number": "651-642-9441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 BANDANA BLVD W",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551085107",
"telephone_number": "651-641-7000",
"fax_number": "651-641-7166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANSBURY",
"first_name": "JOHN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MN",
"license": "20150",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.