Individual provider Active NPI

David Alex Stalker, MD

  • Surgery Physician
  • Clovis, NM
National Provider Identifier
1346299096
Registry record updated Jun 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
87-389 Issued in NM
Practice address
233 Fairway Ter N Ste B
Clovis, NM 88101
Phone
(575) 762-7779
NPI assigned
May 9, 2006
Last updated
Jun 13, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 87-389 NM Primary
General Practice Physician 208D00000X 87-389 NM

Addresses

Primary practice location

233 Fairway Ter N Ste B
Clovis, NM 88101

Mailing address

PO Box 833
Clovis, NM 88102-0833
Phone (575) 762-7779

Other identifiers 4

IdentifierTypeStateIssuer
128595101OtherNMSOUTHWEST LIFE & HEALTH
E9226MedicaidNM
10002070OtherNMLOVELACE HEALTH SYSTEM
NM009Y93OtherNMBLUE CROSS/BLUE SHIELD

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)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528848000000",
    "number": "1346299096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 833",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881020833",
            "telephone_number": "575-762-7779",
            "fax_number": "575-762-3526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 FAIRWAY TER N STE B",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "88101",
            "telephone_number": "575-762-7779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALKER",
        "first_name": "DAVID",
        "middle_name": "ALEX",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2018-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NM",
            "license": "87-389",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NM",
            "license": "87-389",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHWEST LIFE & HEALTH",
            "identifier": "128595101",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "E9226",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOVELACE HEALTH SYSTEM",
            "identifier": "10002070",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "NM009Y93",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2018; 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.