Individual provider Active NPI

David B Stuetelberg, D.C.

  • Chiropractor
  • Georgetown, TX
National Provider Identifier
1063430130
Registry record updated Feb 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6785 Issued in TX
Practice address
400 Del Webb Blvd
Suite 103
Georgetown, TX 78633-4354
Phone
(512) 864-2880
Fax
(512) 864-2411
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6785 TX Primary

Addresses

Primary practice location

400 Del Webb Blvd
Suite 103
Georgetown, TX 78633-4354

Mailing address

400 Del Webb Blvd
Suite 103
Georgetown, TX 78633-4354
Phone (512) 864-2880

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040130000937 TX Practitioner - Chiropractic 7214830785 Practice locations: Georgetown, TX

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

400 Del Webb Blvd
Georgetown, TX 78633-4354
Phone (512) 864-2880

400 Dell Webb
Suite 103
Georgetown, TX 78633-4354

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6785TXMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235606400000",
    "number": "1063430130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 DEL WEBB BLVD",
            "address_2": "SUITE 103",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786334354",
            "telephone_number": "512-864-2880",
            "fax_number": "512-864-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 DEL WEBB BLVD",
            "address_2": "SUITE 103",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786334354",
            "telephone_number": "512-864-2880",
            "fax_number": "512-864-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUETELBERG",
        "first_name": "DAVID",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2009-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "6785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2009; 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.