Individual provider Active NPI

Benjamin Daniel Stills, NMD

  • Naturopath
  • Phoenix, AZ
National Provider Identifier
1376145755
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
20-1919 Issued in AZ
Practice address
640 W Maryland Ave Ste 3
Phoenix, AZ 85013-1398
Phone
(602) 439-0000
Fax
(602) 439-0021
NPI assigned
Nov 11, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X 20-1919 AZ Primary

Addresses

Primary practice location

640 W Maryland Ave Ste 3
Phoenix, AZ 85013-1398

Mailing address

640 W Maryland Ave Ste 3
Phoenix, AZ 85013-1398
Phone (602) 439-0000

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

State licenses

LicenseStateTypeSpecialty
20-1919AZMDNaturopath

Interoperability endpoints

  • Direct secure messaging: benjamin.stills.1@27718.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1605052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1376145755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 W MARYLAND AVE STE 3",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850131398",
            "telephone_number": "602-439-0000",
            "fax_number": "602-439-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 W MARYLAND AVE STE 3",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850131398",
            "telephone_number": "602-439-0000",
            "fax_number": "602-439-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILLS",
        "first_name": "BENJAMIN",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "NMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-11",
        "last_updated": "2020-11-11",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "AZ",
            "license": "20-1919",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 11, 2020; 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.