Individual provider Active NPI

Zachary W Stoller, D.C.

  • Chiropractor
  • Columbus, OH
National Provider Identifier
1033591664
Registry record updated Jun 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4532 Issued in OH
Practice address
1201 S High St
Columbus, OH 43206-3400
Phone
(614) 444-5661
Fax
(614) 444-5662
NPI assigned
Jun 19, 2015
Last updated
Jun 19, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4532 OH Primary

Addresses

Primary practice location

1201 S High St
Columbus, OH 43206-3400

Mailing address

1201 S High St
Columbus, OH 43206-3400
Phone (614) 444-5661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200218001244 SC Practitioner - Chiropractic 8224465034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stoller EnterpriseGroup PAC ID 6709213515, 2 clinicians

Practice addresses (Care Compare)

113 S Main St
Summerville, SC 29483-6007
Phone (843) 873-6004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4532OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Stoller Enterprise Chiropractor CurrentSince Jan 20, 2020 Accepting new patients
Elite Performance and Pain Center LLC Chiropractor PastSince Jan 20, 2020 Accepting new patients

Locations

113 S Main St
Summerville, SC 29483
Phone (843) 871-2472

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434672000000",
    "number": "1033591664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 S HIGH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432063400",
            "telephone_number": "614-444-5661",
            "fax_number": "614-444-5662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S HIGH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432063400",
            "telephone_number": "614-444-5661",
            "fax_number": "614-444-5662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLLER",
        "first_name": "ZACHARY",
        "middle_name": "W",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-19",
        "last_updated": "2015-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "4532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.