Stitle Dermatology, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

01056989A Issued in IN

Legal business name

STITLE DERMATOLOGY, LLC

Practice address

92 S Park Blvd
Greenwood, IN 46143-8836

Phone

(317) 889-7546

Fax

(317) 889-2482

NPI assigned

Apr 17, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Laura T Stitle, M.D.NPI 1457446247

Title

President

Phone

(317) 889-7546

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Laura T Stitle, MD

  • Dermatology Physician
  • Greenwood, IN
  • NPI 1457446247
  Medicare reassignment Authorized official
• Larry J Buckel, MD

  • Dermatopathology Physician
  • Greenwood, IN
  • NPI 1811090939
  NPD
• Thomas J Eads, MD

  • Dermatology Physician
  • Greenwood, IN
  • NPI 1942303151
  NPD

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710979200000",
    "number": "1174797443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 S PARK BLVD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461438836",
            "telephone_number": "317-889-7546",
            "fax_number": "317-889-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 S PARK BLVD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461438836",
            "telephone_number": "317-889-7546",
            "fax_number": "317-889-2482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STITLE DERMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-17",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A",
        "authorized_official_last_name": "STITLE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-889-7546",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01056989A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "HIE",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "92 S Park Blvd",
            "city": "Greenwood",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461438836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jacob Stevens, DMD
• Kristin Stevens, DDS
• Victoria Stewart
• Robert James Stiles, PA-C
• Shelley R Stiner, DO
• Laura T Stitle, MD
• Wendy S. Stoelting-Gettelfinger, NP
• Annie Stone
• Diane M. Stone, LMHC
• Stones Crossing Dentistry Inc

• Dermatology Physician in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Dermatology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.