Individual provider Active NPI

Douglas J Stockwell, M.D.

  • Psychiatry Physician
  • Phoenix, AZ
National Provider Identifier
1518918416
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G5653 Issued in TX
Practice address
500 W Thomas Rd Ste 230
Phoenix, AZ 85013
Phone
(602) 406-9999
Fax
(602) 406-8099
NPI assigned
May 15, 2006
Last updated
Jul 16, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G5653 TX Primary

Addresses

Primary practice location

500 W Thomas Rd Ste 230
Phoenix, AZ 85013

Mailing address

3030 N Central Ave Ste 1001
Phoenix, AZ 85012-2716
Phone (602) 406-4786

Other practice location 1

5959 West Loop S
Suite 600
Bellaire, TX 77401-2421
Phone (713) 669-0303

Other practice location 2

350 W Thomas Rd
Phoenix, AZ 85013-4409
Phone (602) 406-3874

Other practice location 3

5959 West Loop S
Suite 600
Bellaire, TX 77401-2421
Phone (713) 669-0303

Other identifiers 5

IdentifierTypeStateIssuer
114122MedicaidAZ
137426604MedicaidTX
260041159OtherTXRAILROAD MEDICARE
076126OtherTXVALUE OPTIONS
85500XOtherTXBLUE CROSS BLUE SHIELD

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

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1518918416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 N CENTRAL AVE STE 1001",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122716",
            "telephone_number": "602-406-4786",
            "fax_number": "913-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W THOMAS RD STE 230",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85013",
            "telephone_number": "602-406-9999",
            "fax_number": "602-406-8099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5959 West Loop S",
            "address_2": "SUITE 600",
            "address_purpose": "LOCATION",
            "city": "Bellaire",
            "state": "TX",
            "postal_code": "774012421",
            "country_code": "US",
            "telephone_number": "713-669-0303",
            "fax_number": "713-669-0704",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 W Thomas Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850134409",
            "country_code": "US",
            "telephone_number": "602-406-3874",
            "fax_number": "602-212-4768",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5959 West Loop S",
            "address_2": "SUITE 600",
            "address_purpose": "LOCATION",
            "city": "Bellaire",
            "state": "TX",
            "postal_code": "774012421",
            "country_code": "US",
            "telephone_number": "713-669-0303",
            "fax_number": "713-669-0704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOCKWELL",
        "first_name": "DOUGLAS",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "G5653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114122",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137426604",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "260041159",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "076126",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "85500X",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.