Individual provider Active NPI

Daniel Wayne Stock, MD

  • Family Medicine Physician
  • Noblesville, IN
National Provider Identifier
1417961293
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01037735A Issued in IN
Practice address
15510 Herriman Blvd
Noblesville, IN 46060
Phone
(317) 559-2515
Fax
(317) 401-8273
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 01037735A IN
Family Medicine Physician 207Q00000X 01037735A IN Primary

Addresses

Primary practice location

15510 Herriman Blvd
Noblesville, IN 46060

Mailing address

15510 Herriman Blvd
Noblesville, IN 46060
Phone (317) 559-2515

Other identifiers 3

IdentifierTypeStateIssuer
200072890MedicaidIN
000000312845OtherINANTHEM
P00117763OtherINMEDICAID RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040315001518 IN Practitioner - Family Practice 1355231341 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01037735AINMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network CurrentSince May 15, 2016 Accepting new patients
Indiana University Health Urgent Care Centers, LLC CurrentSince Nov 1, 2015 Accepting new patients
Indiana University Health Urgent Care Centers, LLC. Current Accepting new patients
Franciscan Physician Network CurrentSince May 15, 2016 Accepting new patients
Franciscan Physician Network Family Medicine Current Accepting new patients
Indiana University Health Urgent Care Centers, LLC CurrentSince Nov 1, 2015 Accepting new patients
Major Hospital Past Accepting new patients

Locations

90 E Garner Rd
Brownsburg, IN 46112
Phone (225) 214-1031

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

1001 N Madison Ave
Greenwood, IN 46142
Phone (317) 528-7500

996 S State Road 135
Ste P
Greenwood, IN 46143
Phone (317) 893-3888

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1417961293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15510 HERRIMAN BLVD",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "46060",
            "telephone_number": "317-559-2515",
            "fax_number": "317-401-8273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15510 HERRIMAN BLVD",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "46060",
            "telephone_number": "317-559-2515",
            "fax_number": "317-401-8273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCK",
        "first_name": "DANIEL",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "01037735A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01037735A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200072890",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000312845",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID RAILROAD",
            "identifier": "P00117763",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Noblesville, IN

Sources for this page

Verify at the official NPI Registry.