Active NPI
Lindsay W Stadtler, MD
- Pediatrics Physician
- Fort Worth, TX
National Provider Identifier
1174608335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- L6188
- Practice address
- 6210 John Ryan Dr
Ste 104
Fort Worth, TX 76132-4113 - Phone
- (817) 294-7578
- Fax
- (817) 294-0585
- NPI assigned
- Oct 26, 2006
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | L6188 | TX | Primary |
Addresses
Primary practice location
6210 John Ryan Dr
Ste 104
Fort Worth, TX 76132-4113
Mailing address
PO Box 99371
Fort Worth, TX 76199-0371
Phone (682) 885-1855
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 162742401 | Medicaid | TX | |
| 1750369203 | Other | GRP NPI NUMBER | |
| 2360144 | Other | TX | UHC PIN |
| STAL058704 | Other | TX | CCHIP PIN |
| 00U87Z | Other | TX | BCSTX GRP PIN |
| 140442852 | Medicaid | TX | |
| 8K3191 | Other | TX | BCBSTX IND PIN |
| 140442893 | Medicaid | TX | |
| 2146971 | Other | TX | FIRSTHEATLH PIN |
| 7489549 | Other | TX | AETNA PIN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| L6188 | TX | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271721600000",
"number": "1174608335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 99371",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761990371",
"telephone_number": "682-885-1855",
"fax_number": "682-885-7347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6210 JOHN RYAN DR",
"address_2": "STE 104",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761324113",
"telephone_number": "817-294-7578",
"fax_number": "817-294-0585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STADTLER",
"first_name": "LINDSAY",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-26",
"last_updated": "2010-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "L6188",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "162742401",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GRP NPI NUMBER",
"identifier": "1750369203",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC PIN",
"identifier": "2360144",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CCHIP PIN",
"identifier": "STAL058704",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCSTX GRP PIN",
"identifier": "00U87Z",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "140442852",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSTX IND PIN",
"identifier": "8K3191",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "140442893",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRSTHEATLH PIN",
"identifier": "2146971",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PIN",
"identifier": "7489549",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.