Active NPI
David Ellis Stinchcomb, M.D.
- Ophthalmology Physician
- Corrales, NM
National Provider Identifier
1184627697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 68-183
- Practice address
- 122 Via Oreada
Corrales, NM 87048-7434 - Phone
- (505) 898-2255
- Fax
- (505) 898-1370
- NPI assigned
- May 30, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 68-183 | NM | Primary |
Addresses
Primary practice location
122 Via Oreada
Corrales, NM 87048-7434
Mailing address
PO Box 2278
Corrales, NM 87048-2278
Phone (505) 898-2255
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 |
|---|---|---|---|
| 68183 | NM | MD | School Registered Nurse |
| 68-183 | NM | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184627697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2278",
"city": "CORRALES",
"state": "NM",
"postal_code": "870482278",
"telephone_number": "505-898-2255",
"fax_number": "505-898-1370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "122 VIA OREADA",
"city": "CORRALES",
"state": "NM",
"postal_code": "870487434",
"telephone_number": "505-898-2255",
"fax_number": "505-898-1370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STINCHCOMB",
"first_name": "DAVID",
"middle_name": "ELLIS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-05-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NM",
"license": "68-183",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corrales, NM
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.