Individual provider Active NPI

Shaun P Stuto, D.C.

  • Chiropractor
  • Missoula, MT
National Provider Identifier
1124250758
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1202 Issued in MT
Practice address
2825 Stockyard Rd Ste A17
Missoula, MT 59808-1545
Phone
(406) 728-1250
Fax
(406) 728-1279
NPI assigned
Aug 15, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1202 MT Primary

Addresses

Primary practice location

2825 Stockyard Rd Ste A17
Missoula, MT 59808-1545

Mailing address

2825 Stockyard Rd Ste A17
Missoula, MT 59808-1545
Phone (406) 728-1250

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150617000949 MT Practitioner - Chiropractic 2466763438 Reassigns benefits to 1 organization
Practice locations: Missoula, MT

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2825 Stockyard Rd
Suite A17
Missoula, MT 59808-1545
Phone (406) 728-1250

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1202MTMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Optimum Health and Wellness, PLLC Chiropractor Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1250294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1124250758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 STOCKYARD RD STE A17",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081545",
            "telephone_number": "406-728-1250",
            "fax_number": "406-728-1279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 STOCKYARD RD STE A17",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081545",
            "telephone_number": "406-728-1250",
            "fax_number": "406-728-1279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUTO",
        "first_name": "SHAUN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-15",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MT",
            "license": "1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.