Organization Active NPI

Christopher R Stull D.C.P.C.

  • Chiropractor
  • Broomfield, CO
National Provider Identifier
1255560637
Registry record updated Aug 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6377 Issued in CO
Legal business name
CHRISTOPHER R STULL D.C.P.C.
Practice address
12995 Sheridan Blvd
#101
Broomfield, CO 80020-1480
Phone
(303) 466-3988
Fax
(303) 466-3878
NPI assigned
Jul 7, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2012

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

Authorized official

Name
Dr. Christopher Robert Stull, D.C.NPI 1568699759
Title
President
Phone
(563) 505-1731

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 6377 CO Primary

Addresses

Primary practice location

12995 Sheridan Blvd
#101
Broomfield, CO 80020-1480

Mailing address

12995 Sheridan Blvd
#101
Broomfield, CO 80020-1480
Phone (303) 466-3988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130419000040 CO Part B Supplier - Clinic/Group Practice 0244476109 Receives reassigned benefits from 1 practitioner
Practice locations: Broomfield, CO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1246924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345420800000",
    "number": "1255560637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12995 SHERIDAN BLVD",
            "address_2": "#101",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800201480",
            "telephone_number": "303-466-3988",
            "fax_number": "303-466-3878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12995 SHERIDAN BLVD",
            "address_2": "#101",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800201480",
            "telephone_number": "303-466-3988",
            "fax_number": "303-466-3878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTOPHER R STULL D.C.P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-07",
        "last_updated": "2012-08-20",
        "status": "A",
        "authorized_official_last_name": "STULL",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "563-505-1731",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "6377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2012; 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.