Individual provider Active NPI

Stephen Gilman, DC

  • Chiropractor
  • Phoenix, AZ
National Provider Identifier
1336295625
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7201 Issued in AZ
Practice address
3830 W Rue de Lamour Ave
Phoenix, AZ 85029-1153
Phone
(602) 418-3766
Fax
(623) 516-8699
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7201 AZ Primary

Addresses

Primary practice location

3830 W Rue de Lamour Ave
Phoenix, AZ 85029-1153

Mailing address

3830 W Rue de Lamour Ave
Phoenix, AZ 85029-1153
Phone (602) 418-3766

Other identifiers 1

IdentifierTypeStateIssuer
AZ0935150OtherAZBCBS PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336295625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3830 W RUE DE LAMOUR AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850291153",
            "telephone_number": "602-418-3766",
            "fax_number": "623-516-8699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 W RUE DE LAMOUR AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850291153",
            "telephone_number": "602-418-3766",
            "fax_number": "623-516-8699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMAN",
        "first_name": "STEPHEN",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "AZ0935150",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.