Active NPI
Wayne Joe Stock, RN
- Homemaker
- Canon City, CO
National Provider Identifier
1417628504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homemaker
- Practice address
- 1415 N 15TH St
Canon City, CO 81212-4624 - Phone
- (719) 276-1105
- NPI assigned
- Sep 28, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Homemaker | 376J00000X | Primary |
Addresses
Primary practice location
1415 N 15TH St
Canon City, CO 81212-4624
Mailing address
815 Garden Park Rd
Canon City, CO 81212-8315
Phone (719) 276-1105
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
- Credentials
- Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safe Watch, Inc. | Current | Accepting new patients | |
| Safe Watch, Inc. | Current | Accepting new patients |
Locations
1415 N 15th St
Canon City, CO 81212
Phone (719) 275-2034
Organizations & group practices 2
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.
-
- Home Health Agency
- Canon City, CO
- NPI 1275290678
-
- Home Health Agency
- Canon City, CO
- NPI 1891913869
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632787200000",
"number": "1417628504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 GARDEN PARK RD",
"city": "CANON CITY",
"state": "CO",
"postal_code": "812128315",
"telephone_number": "719-276-1105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1415 N 15TH ST",
"city": "CANON CITY",
"state": "CO",
"postal_code": "812124624",
"telephone_number": "719-276-1105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOCK",
"first_name": "WAYNE",
"middle_name": "JOE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-09-28",
"last_updated": "2021-09-28",
"certification_date": "2021-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Canon City, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.