Active NPI
Cameron Stukel, DPT
- Physical Therapist
- Driggs, ID
National Provider Identifier
1104700319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 7671668
- Practice address
- 39 W Little Ave
Driggs, ID 83422-5021 - Phone
- (208) 354-9675
- NPI assigned
- Aug 1, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 7671668 | ID | Primary |
Addresses
Primary practice location
39 W Little Ave
Driggs, ID 83422-5021
Mailing address
PO Box 342
Tetonia, ID 83452-0342
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY, ID
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
107 W Little Ave Unit
Suite 2
Driggs, ID 83422-5158
Phone (307) 734-9129
120 W Pearl Ave
Suite F
Jackson, WY 83001-8657
Phone (307) 734-9129
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7671668 | ID | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Excel Physical Therapy, LLC | Physical Therapist | Current | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754006400000",
"number": "1104700319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 342",
"city": "TETONIA",
"state": "ID",
"postal_code": "834520342"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39 W LITTLE AVE",
"city": "DRIGGS",
"state": "ID",
"postal_code": "834225021",
"telephone_number": "208-354-9675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STUKEL",
"first_name": "CAMERON",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-08-01",
"last_updated": "2025-08-01",
"certification_date": "2025-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "7671668",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Driggs, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2025; 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.