Christopher J Stadtherr, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD60076499 Issued in WA

Practice address

2520 Cherry Ave
Bremerton, WA 98310-4229

Phone

(360) 377-3911

NPI assigned

Apr 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2023 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Revitalize Metabolic Health PLLC

  • Clinic/Center
  • Gig Harbor, WA
  • NPI 1770168924
  NPD Authorized official

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265673600000",
    "number": "1437115532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 CHERRY AVE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983104229",
            "telephone_number": "360-377-3911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 CHERRY AVE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983104229",
            "telephone_number": "360-377-3911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STADTHERR",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2010-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "47105",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60076499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Suzanne Sprunk, CCC-SP, CBIS
• Jennifer Danielle Squazza
• Daniel St.Clair
• Sabrina Staaf
• Randi Stacy
• Brenda Stagner
• Mary Louise Stahlhuth, MFT
• Lynn Leroy Staker, MD
• Cynthia Patricia Staley, MPT
• Imagany Stallworth

• Family Medicine Physician in Bremerton, WA
• Providers in Bremerton, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.