Thomas Christian Stjernholm, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

19501 Issued in CO

Practice address

3670 Parker Blvd Ste 101
Pueblo, CO 81008-2285

Phone

(719) 564-1544

Fax

(719) 924-1593

NPI assigned

May 31, 2006

Last updated

Sep 20, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Trinidad Area Health Association

  dba Mt. San Rafael Hospital Clinic

  • Family Medicine Physician
  • Trinidad, CO
  • NPI 1467400309
  NPD (past)

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379635200000",
    "number": "1083651244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3670 PARKER BLVD STE 101",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082285",
            "telephone_number": "719-564-1544",
            "fax_number": "719-924-1593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3670 PARKER BLVD STE 101",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082285",
            "telephone_number": "719-564-1544",
            "fax_number": "719-924-1593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STJERNHOLM",
        "first_name": "THOMAS",
        "middle_name": "CHRISTIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2013-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CO",
            "license": "19501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01195015",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00997272",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krysta Stickler, D.C.
• Susan B Stiller, LCSW
• Lisa Stiner, RDH
• Richard M Stiphout, MD
• James R Stjernholm, M.D.
• Camila Stocking
• Chalanne Stockman, NURSE PRACTITIONER
• Shad Rick Stockton, NBC-HIS
• Kathryn Stone, NP-C
• Cynthia Yvette Story, COTA

• Cardiovascular Disease Physician in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Cardiovascular Disease Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; 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.