Individual provider Active NPI

William Thomas Stillwell, M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Lake Mary, FL
National Provider Identifier
1437595675
Registry record updated May 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
ME89370 Issued in FL
Practice address
4044 W Lake Mary Blvd
#104-345
Lake Mary, FL 32746-2012
Phone
(407) 455-2555
Fax
(407) 333-1071
NPI assigned
May 15, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X ME89370 FL Primary

Addresses

Primary practice location

4044 W Lake Mary Blvd
#104-345
Lake Mary, FL 32746-2012

Mailing address

4044 W Lake Mary Blvd
#104-345
Lake Mary, FL 32746-2012
Phone (407) 455-2555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170223002350 FL Order and Referring Only - Orthopedic SurgeryPractitioner - Orthopedic SurgeryPractitioner - Other (Physician) 0547544231

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME89370FLMDAdult Reconstructive Orthopaedic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1368576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368576000000",
    "number": "1437595675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4044 W LAKE MARY BLVD",
            "address_2": "#104-345",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462012",
            "telephone_number": "407-455-2555",
            "fax_number": "407-333-1071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4044 W LAKE MARY BLVD",
            "address_2": "#104-345",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462012",
            "telephone_number": "407-455-2555",
            "fax_number": "407-333-1071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILLWELL",
        "first_name": "WILLIAM",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-15",
        "last_updated": "2013-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "FL",
            "license": "ME89370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.