Individual provider Active NPI

Philip Martin Stoll, D.O., D.D.S.

  • Anatomic Pathology & Clinical Pathology Physician
  • Norfolk, VA
National Provider Identifier
1023052438
Registry record updated Nov 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
0102050003 Issued in VA
Practice address
830 Southampton Ave
Suite 100
Norfolk, VA 23510-1001
Phone
(757) 683-8366
Fax
(757) 683-2589
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 0102050003 VA Primary

Addresses

Primary practice location

830 Southampton Ave
Suite 100
Norfolk, VA 23510-1001

Mailing address

4116 Stephanie Boyd Dr
Chesapeake, VA 23321-4423
Phone (757) 620-5158

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)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0102050003VAMDAnatomic Pathology & Clinical Pathology Physician

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289433600000",
    "number": "1023052438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4116 STEPHANIE BOYD DR",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233214423",
            "telephone_number": "757-620-5158",
            "fax_number": "757-465-3527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 SOUTHAMPTON AVE",
            "address_2": "SUITE 100",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101001",
            "telephone_number": "757-683-8366",
            "fax_number": "757-683-2589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLL",
        "first_name": "PHILIP",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "D.O., D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2010-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "VA",
            "license": "0102050003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.