Active NPI
Terrence A Stoll, M.D.
- Specialist
- Garden City, ID
National Provider Identifier
1447288121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- M6733
- Practice address
- 8540 W Atwater Dr
Garden City, ID 83714-1801 - Phone
- (208) 880-6010
- NPI assigned
- Jun 29, 2006
- 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 13
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | M6733 | ID | Primary |
| Diagnostic Radiology Physician | 2085R0202X | MD 00047952 | WA | |
| Diagnostic Ultrasound Physician | 2085U0001X | MD 00047952 | WA | |
| Body Imaging Physician | 2085B0100X | MD 00047952 | WA | |
| Nuclear Radiology Physician | 2085N0904X | MD 00047952 | WA | |
| Pediatric Radiology Physician | 2085P0229X | MD 00047952 | WA | |
| Vascular & Interventional Radiology Physician | 2085R0204X | MD 00047952 | WA | |
| Neuroradiology Physician | 2085N0700X | MD 00047952 | WA | |
| Diagnostic Radiology Physician | 2085R0202X | M6733 | ID | |
| Diagnostic Radiology Physician | 2085R0202X | 3929 | ND | |
| Specialist | 174400000X | MD 00047952 | WA | |
| Specialist | 174400000X | 3929 | ND | |
| Specialist | 174400000X | 2963A | WY |
Addresses
Primary practice location
8540 W Atwater Dr
Garden City, ID 83714-1801
Mailing address
8540 W Atwater Dr
Garden City, ID 83714-1801
Phone (208) 880-6010
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003929000 | Medicaid | ID |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M6733 | ID | MD | Specialist |
| 3929 | ND | MD | Specialist |
| 2963A | WY | MD | Specialist |
| MD 00047952 | WA | MD | Nuclear Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288656000000",
"number": "1447288121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8540 W ATWATER DR",
"city": "GARDEN CITY",
"state": "ID",
"postal_code": "837141801",
"telephone_number": "208-880-6010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8540 W ATWATER DR",
"city": "GARDEN CITY",
"state": "ID",
"postal_code": "837141801",
"telephone_number": "208-880-6010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOLL",
"first_name": "TERRENCE",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-29",
"last_updated": "2010-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "ID",
"license": "M6733",
"primary": true
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "WA",
"license": "MD 00047952",
"primary": false
},
{
"code": "2085U0001X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Ultrasound",
"state": "WA",
"license": "MD 00047952",
"primary": false
},
{
"code": "2085B0100X",
"taxonomy_group": "",
"desc": "Radiology, Body Imaging",
"state": "WA",
"license": "MD 00047952",
"primary": false
},
{
"code": "2085N0904X",
"taxonomy_group": "",
"desc": "Radiology, Nuclear Radiology",
"state": "WA",
"license": "MD 00047952",
"primary": false
},
{
"code": "2085P0229X",
"taxonomy_group": "",
"desc": "Radiology, Pediatric Radiology",
"state": "WA",
"license": "MD 00047952",
"primary": false
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "WA",
"license": "MD 00047952",
"primary": false
},
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "WA",
"license": "MD 00047952",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "ID",
"license": "M6733",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "ND",
"license": "3929",
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MD 00047952",
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "ND",
"license": "3929",
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WY",
"license": "2963A",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003929000",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Garden City, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.