Michael Shawn Stockman, CRNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

R073180 Issued in MD

Practice address

440 Koonce Rd
Harpers Ferry, WV 25425-3126

Phone

(304) 724-5918

Fax

(304) 724-5920

NPI assigned

Jun 16, 2005

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255996800000",
    "number": "1326043365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5408 BARTONSVILLE RD",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217046802",
            "telephone_number": "301-694-0715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 KOONCE RD",
            "city": "HARPERS FERRY",
            "state": "WV",
            "postal_code": "254253126",
            "telephone_number": "304-724-5918",
            "fax_number": "304-724-5920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKMAN",
        "first_name": "MICHAEL",
        "middle_name": "SHAWN",
        "name_prefix": "Mr.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2009-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R073180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00748732",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heidi Carter Simmons, MSPT
• Belinda E Smith, MA, LCPC
• Edward Reynolds Smith, D.D.S.
• Eleanor A Smith, M.D.
• Danielle Nicole Stevens
• Andrew Sulistio, MD
• Megan Sullivan
• Sherry Marie Summers
• Michael Peter Sutton, MD
• Mone Taylor

• Adult Health Nurse Practitioner in Harpers Ferry, WV
• Providers in Harpers Ferry, WV by specialty
• Adult Health Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.