Individual provider Active NPI

John Roderick Stahl Jr., PH.D.

  • Psychologist
  • Taunton, MA
National Provider Identifier
1194827634
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1830 Issued in MA
Practice address
7 Dean St
Taunton, MA 02780-2725
Phone
(508) 822-0006
Fax
(508) 880-5389
NPI assigned
Sep 4, 2006
Sex
Male
Sole proprietor
Yes

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
Psychologist 103T00000X 1830 MA Primary

Addresses

Primary practice location

7 Dean St
Taunton, MA 02780-2725

Mailing address

7 Dean St
Taunton, MA 02780-2725
Phone (508) 822-0006

Other identifiers 11

IdentifierTypeStateIssuer
94690OtherMAMHN
000953OtherMAHARVARDPILGRIMHEALTHCARE
000953OtherMAVALUE OPTIONS
5904732OtherMAAETNA
S018364OtherMACHAMPUS
61-09958OtherMAUBH/UNITED HEALTHCARE
STW02009OtherMABCBS MA
0503080MedicaidMA
705734OtherMATUFTS HEALTHCARE
213470OtherMABEACON
30261-0OtherRIBCBS RI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070703000158 MA Practitioner - Clinical Psychologist 6305946435 Practice locations: Taunton, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7 Dean St
Taunton, MA 02780-2725
Phone (508) 822-0006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1830MAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Behavioral Health, LLC Psychologist PastSince Jul 1, 2006 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194827634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 DEAN ST",
            "city": "TAUNTON",
            "state": "MA",
            "postal_code": "027802725",
            "telephone_number": "508-822-0006",
            "fax_number": "508-880-5389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 DEAN ST",
            "city": "TAUNTON",
            "state": "MA",
            "postal_code": "027802725",
            "telephone_number": "508-822-0006",
            "fax_number": "508-880-5389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAHL",
        "first_name": "JOHN",
        "middle_name": "RODERICK",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "1830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "94690",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARDPILGRIMHEALTHCARE",
            "identifier": "000953",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "000953",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5904732",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "S018364",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH/UNITED HEALTHCARE",
            "identifier": "61-09958",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "STW02009",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0503080",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTHCARE",
            "identifier": "705734",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON",
            "identifier": "213470",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS RI",
            "identifier": "30261-0",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Taunton, MA

Sources for this page

Verify at the official NPI Registry.