Individual provider Active NPI

Craig L Stabler, M.D.

  • Orthopaedic Surgery Physician
  • Williamsport, PA
National Provider Identifier
1124098256
Registry record updated Jan 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD038114E Issued in PA
Practice address
699 Rural Ave
Suite 101
Williamsport, PA 17701-3246
Phone
(570) 322-3640
Fax
(570) 322-3656
NPI assigned
Jan 23, 2006
Reactivated
Jan 23, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD038114E PA Primary

Addresses

Primary practice location

699 Rural Ave
Suite 101
Williamsport, PA 17701-3246

Mailing address

204 Cliffside Dr
Williamsport, PA 17701-1830
Phone (570) 368-8139

Other identifiers 1

IdentifierTypeStateIssuer
001082421MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD038114EPAMDOrthopaedic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516665600000",
    "number": "1124098256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 CLIFFSIDE DR",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011830",
            "telephone_number": "570-368-8139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 RURAL AVE",
            "address_2": "SUITE 101",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177013246",
            "telephone_number": "570-322-3640",
            "fax_number": "570-322-3656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STABLER",
        "first_name": "CRAIG",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2018-01-23",
        "deactivation_date": "2013-07-30",
        "reactivation_date": "2018-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MD038114E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001082421",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2018; 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.