John Evan Stollberg, OTD, OTR/L, CHT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

101897 Issued in IA

Practice address

3100 S Lakeport St
Sioux City, IA 51106-4222

Phone

(712) 277-4442

Fax

(712) 202-0578

NPI assigned

Apr 28, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA, SD2 enrollments

Enrollment records 2

Specialty

Occupational Therapist in Private Practice

Education

Creighton University School of Medicine, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• HS Occupational Wellness LLC

  • Physical Therapist
  • Sioux City, IA
  • NPI 1982202180

  SD

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1430179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1295112340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 S LAKEPORT ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511064222",
            "telephone_number": "712-277-4442",
            "fax_number": "712-202-0578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 S LAKEPORT ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511064222",
            "telephone_number": "712-277-4442",
            "fax_number": "712-202-0578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLLBERG",
        "first_name": "JOHN",
        "middle_name": "EVAN",
        "credential": "OTD, OTR/L, CHT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-28",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": "101897",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KS",
            "license": "17-03060",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Stines
• Jennifer Lynn Stinton, BA, CCDP
• Corey Stocco, PH.D., BCBA
• Stokes and Associates, LLC
• Tyler Jerome Stolen, DC
• Traci Lynn Stone, MSE, ATC, LAT, CSCS
• Karen E Stoos, ARNP
• Kimberly Stowe, NURSE PRACTITIONER
• Amy Strim, ARNP
• Kimberly Marie Stroeh, PHARMD

• Occupational Therapist in Sioux City, IA
• Providers in Sioux City, IA by specialty
• Occupational Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.