Christopher Jon Stark

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

DR.0058428 Issued in CO

Practice address

400 W 16TH St
Pueblo, CO 81003-2745

Phone

(719) 595-2218

Fax

(719) 595-7994

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Dr. Christoper J Stark Professional name

Medicare fee-for-service enrollment

Enrolled in KY, CO2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Huerfano County Hospital District

  • Rural Health Clinic/Center
  • Walsenburg, CO
  • NPI 1154799526
  Medicare reassignment NPD
• Southeastern Physician Services PC

  • Hospitalist Physician
  • Oak Ridge, TN
  • NPI 1083835441

  Internal Medicine, KY

  Medicare reassignment NPD
• Huerfano County Hospital District

  • Surgery Physician
  • Walsenburg, CO
  • NPI 1164835419
  Medicare reassignment
• Huerfano County Hospital District

  • Non-Surgical Family Planning Clinic/Center
  • Walsenburg, CO
  • NPI 1346403375
  Medicare reassignment
• Huerfano County Hospital District

  • Primary Care Clinic/Center
  • La Veta, CO
  • NPI 1760851737
  Medicare reassignment
• Prowers County Hospital District

  • Critical Access Hospital
  • Lamar, CO
  • NPI 1821052929
  Medicare reassignment
• Hospitalist Associates of Lexington

  • Hospitalist Physician
  • Danville, KY
  • NPI 1982833596
  Medicare reassignment
• Associated Physician Services of Lexington, LLC

  • Nurse Practitioner
  • Lexington, KY
  • NPI 1285685974

  Internal Medicine

  NPD (past)
• Family Care Clinic, PLLC

  • Rural Health Clinic/Center
  • Mt Sterling, KY
  • NPI 1285655167
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1013936764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 560825",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802560825",
            "telephone_number": "719-595-7580",
            "fax_number": "719-545-0176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W 16TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032745",
            "telephone_number": "719-595-2218",
            "fax_number": "719-595-7994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "CHRISTOPHER",
        "middle_name": "JON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "39876",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MN",
            "license": "50157",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CO",
            "license": "DR.0058428",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0058428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64125065",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000147685",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTOPER",
            "last_name": "STARK",
            "middle_name": "J",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Devin Leah Staniar, PA
• Stanley C. Rheaume, DPM, PC
• Diane Clare Stapleton, L.P.C.
• Kenzie L Stapleton
• Star Rehab Therapy LLC
• State of Colorado
• State of Colorado
• State of Grace
• State of Grace
• Steel City Behavioral Health, LLC

• Internal Medicine Physician in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Internal Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.