Individual provider Active NPI

Kenneth Stemmle, MD

  • Family Medicine Physician
  • Cameron Park, CA
National Provider Identifier
1154312585
Registry record updated Aug 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G21257 Issued in CA
Practice address
3581 Palmer Dr
Suite 602
Cameron Park, CA 95682-8236
Phone
(530) 626-2920
Fax
(530) 672-7048
NPI assigned
Nov 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G21257 CA Primary

Addresses

Primary practice location

3581 Palmer Dr
Suite 602
Cameron Park, CA 95682-8236

Mailing address

3581 Palmer Dr
Suite 602
Cameron Park, CA 95682-8236
Phone (530) 626-2920

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

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251158400000",
    "number": "1154312585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3581 PALMER DR",
            "address_2": "SUITE 602",
            "city": "CAMERON PARK",
            "state": "CA",
            "postal_code": "956828236",
            "telephone_number": "530-626-2920",
            "fax_number": "530-672-7048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3581 PALMER DR",
            "address_2": "SUITE 602",
            "city": "CAMERON PARK",
            "state": "CA",
            "postal_code": "956828236",
            "telephone_number": "530-626-2920",
            "fax_number": "530-672-7048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEMMLE",
        "first_name": "KENNETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2009-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G21257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cameron Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2009; 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.