Kristin Stahl MD PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

036100294 Issued in IL

Legal business name

KRISTIN STAHL MD PC

Doing business as

Dale Avenue Pediatrics
Heartland Pediatrics

Practice address

101 United Dr
Suite 110
Collinsville, IL 62234-7428

Phone

(618) 855-9041

Fax

(618) 855-9046

NPI assigned

Dec 11, 2006

Last updated

Apr 15, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Kristin E Stahl

Title

Billing Manager

Phone

(314) 833-5437

Specialties & licenses 2

Addresses

Other identifiers 9

Other names 2

• Dale Avenue Pediatrics Doing business as
• Heartland Pediatrics Doing business as

Electronic endpoints 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kristin V Stahl, M.D

  • Pediatric Adolescent Medicine Physician
  • Collinsville, IL
  • NPI 1942369145

  Single Specialty

  NPD
• Valerie J Griffin, APRN BC

  • Pediatric Nurse Practitioner
  • Glen Carbon, IL
  • NPI 1407021504
  NPD (past)
• Li Ling Lai, MD

  • Pediatrics Physician
  • Collinsville, IL
  • NPI 1114901725
  NPD (past)
• Sarah Grace O'Grady, M.D.

  • Pediatrics Physician
  • Collinsville, IL
  • NPI 1740415587
  NPD (past)
• Gretchen Sander, M.D.

  • Pediatrics Physician
  • Collinsville, IL
  • NPI 1427256486
  NPD (past)

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744675200000",
    "number": "1336209329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 UNITED DR",
            "address_2": "SUITE 110",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622347428",
            "telephone_number": "618-855-9041",
            "fax_number": "618-855-9046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 UNITED DR",
            "address_2": "SUITE 110",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622347428",
            "telephone_number": "618-855-9041",
            "fax_number": "618-855-9046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTIN STAHL MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A",
        "authorized_official_last_name": "STAHL",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "314-833-5437",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "036100294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1202462",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "164815",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "412708",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ILLINOIS",
            "identifier": "6032067",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0361002943",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE OF MISSOURI",
            "identifier": "119414",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "PC19811",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "205323819",
            "identifier": "205323819",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7084003",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "HIE",
            "affiliation": "Y",
            "affiliationName": "St. Louis Children's Hospital",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "101 United Dr",
            "address_2": "Suite 110",
            "city": "Collinsville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622347428",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "HIE",
            "affiliation": "Y",
            "affiliationName": "St. Louis Children's Hospital",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7600 Dale Ave",
            "city": "Richmond Heights",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631172132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Dale Avenue Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heartland Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Primary Care Clinic/Center in Collinsville, IL
• Providers in Collinsville, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.