Caryn Leslie Stoller, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

036098980 Issued in IL

Practice address

1111 N Northshore Dr Ste S490
Knoxville, TN 37919-2808

Phone

(865) 584-0171

Fax

(865) 584-0174

NPI assigned

Jun 28, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

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.

• The Northshore Group, Inc.

  • Clinical Psychologist
  • Knoxville, TN
  • NPI 1790423366
  NPD

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1023215423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 N NORTHSHORE DR STE S490",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379192808",
            "telephone_number": "865-584-0171",
            "fax_number": "865-584-0174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N NORTHSHORE DR STE S490",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379192808",
            "telephone_number": "865-584-0171",
            "fax_number": "865-584-0174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLLER",
        "first_name": "CARYN",
        "middle_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-28",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "036098980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036098980",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Stokes
• Hannah Stokes, PA-C
• Jonathan Alexander Stokes, MSSW
• Nathan Stokes, DPT
• Rachel Lynn Stokes, M.S., CF-SLP
• Eric K. Stone, N.P.
• Kimberly Grace Stone, PHARMD
• Lauren Joy Stone, OD
• Samantha Ann Stone, BS
• Sue Carol Stone, M.A.

• Child & Adolescent Psychiatry Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Child & Adolescent Psychiatry Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.