Individual provider Active NPI

John Harvard Stiltner, DC

  • Chiropractor
  • Centralia, WA
National Provider Identifier
1154448371
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00001103 Issued in WA
Practice address
1218 Harrison Avenue
Centralia, WA 98531
Phone
(360) 736-0145
Fax
(360) 736-0146
NPI assigned
Mar 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00001103 WA Primary

Addresses

Primary practice location

1218 Harrison Avenue
Centralia, WA 98531

Mailing address

1218 Harrison Avenue
Centralia, WA 98531
Phone (360) 736-0145

Other identifiers 2

IdentifierTypeStateIssuer
ST0456OtherWAREGENCE
14878OtherWAL AND I

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

State licenses

LicenseStateTypeSpecialty
1103WAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154448371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 HARRISON AVENUE",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "98531",
            "telephone_number": "360-736-0145",
            "fax_number": "360-736-0146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 HARRISON AVENUE",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "98531",
            "telephone_number": "360-736-0145",
            "fax_number": "360-736-0146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILTNER",
        "first_name": "JOHN",
        "middle_name": "HARVARD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00001103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "ST0456",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L AND I",
            "identifier": "14878",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.