James R Stjernholm, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

21602 Issued in CO

Practice address

1925 E Orman Ave
Suite 535a
Pueblo, CO 81004-3537

Phone

(719) 564-0450

Fax

(719) 564-1659

NPI assigned

Aug 13, 2006

Last updated

Apr 29, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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

• Heritage Internal Medicine, PC

  • Internal Medicine Physician
  • Pueblo, CO
  • NPI 1669681581
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1275545469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 E ORMAN AVE",
            "address_2": "SUITE 535A",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043537",
            "telephone_number": "719-564-0450",
            "fax_number": "719-564-1659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 E ORMAN AVE",
            "address_2": "SUITE 535A",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043537",
            "telephone_number": "719-564-0450",
            "fax_number": "719-564-1659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STJERNHOLM",
        "first_name": "JAMES",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "21602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01216027",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Derek Wade Stickler, D.C.
• Krysta Stickler, D.C.
• Susan B Stiller, LCSW
• Lisa Stiner, RDH
• Richard M Stiphout, MD
• Thomas Christian Stjernholm, M.D.
• Camila Stocking
• Chalanne Stockman, NURSE PRACTITIONER
• Shad Rick Stockton, NBC-HIS
• Kathryn Stone, NP-C

• Internal Medicine Physician in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Internal Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.