Active NPI
Timothy Stidham, MD
- Pediatric Critical Care Medicine Physician
- Aurora, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- MD2019-0698
- Practice address
- 13123 E 16TH Ave
Aurora, CO 80045-7106 - Phone
- (720) 777-1234
- NPI assigned
- Jul 18, 2007
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Critical Care Medicine Physician | 2080P0203X | 59214 | MT | |
| Pediatric Critical Care Medicine Physician | 2080P0203X | MD2019-0698 | NM | Primary |
| Pediatrics Physician | 208000000X | 48502 | CO | |
| Pediatric Critical Care Medicine Physician | 2080P0203X | 48502 | CO |
Addresses
Primary practice location
13123 E 16TH Ave
Aurora, CO 80045-7106
Mailing address
PO Box 110429
Aurora, CO 80042-0429
Other practice location 1
310 Sunnyview Ln
Kalispell, MT 59901-3129
Phone (406) 751-5310
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43622771 | Medicaid | CO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | krmcmedicalrecords@krhdirect.org | Kalispell Regional Medical Center Inc |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO, MT, NM, IL, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 5
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Other, 2007
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4000 Ambassador Dr
Anchorage, AK 99508-5909
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48502 | CO | MD | Pediatric Critical Care Medicine Physician |
| 59214 | MT | MD | Pediatric Critical Care Medicine Physician |
| MD2019-0698 | NM | MD | Pediatric Critical Care Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ou Health Partners, Inc | Current | Accepting new patients | |
| Denver Health and Hospital Authority | Current | Accepting new patients | |
| Alaska Native Tribal Health Consortium | Current | Accepting new patients | |
| Kalispell Regional Medical Center, Inc | Current | Accepting new patients | |
| Kalispell Regional Medical Center Inc | Current | Accepting new patients | |
| Ou Health Partners, Inc | Current | Accepting new patients | |
| Kalispell Regional Medical Center Inc | Current | Accepting new patients | |
| University Physicians Incorporated | Current | Accepting new patients | |
| Unm Medical Group Inc | Current | Accepting new patients | |
| Denver Health and Hospital Authority | Current | Accepting new patients | |
| Unm Medical Group, Inc. | Current | Accepting new patients | |
| Carle Health Care Incorporated | Family Medicine | Current | Accepting new patients |
| Kalispell Regional Medical Center Inc | Past | Accepting new patients | |
| Kalispell Regional Medical Center, Inc | Past | Accepting new patients |
Locations
13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846
777 Bannock St
Denver, CO 80204
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
310 Sunnyview Ln
Kalispell, MT 59901
Phone (406) 751-5310
350 Heritage Way
Ste 2100
Kalispell, MT 59901
Phone (406) 257-8992
933 Bradbury Dr SE
Ste 2222
Albuquerque, NM 87106
Phone (505) 272-1476
2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111
900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230
Interoperability endpoints
- krmcmedicalrecords@krhdirect.org
- tstidhammd440830@carlehiedirect.net
- tstidham139114@direct.dhha.org
Organizations & group practices 15
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.
-
- General Practice Physician
- Denver, CO
- NPI 1477569838
-
- Internal Medicine Physician
- Urbana, IL
- NPI 1154653947
Family Medicine
-
- Multi-Specialty Clinic/Center
- Albuquerque, NM
- NPI 1831218627
-
- General Acute Care Hospital
- Kalispell, MT
- NPI 1417945627
-
- Internal Medicine Physician
- Aurora, CO
- NPI 1962461889
-
- Psychiatric Hospital Unit
- Denver, CO
- NPI 1689624942
-
- Surgery Physician
- Highlands Ranch, CO
- NPI 1922572833
-
- Maternal & Fetal Medicine Physician
- Kalispell, MT
- NPI 1053798710
-
- Clinic/Center
- Kalispell, MT
- NPI 1235333139
-
- Radiology Clinic/Center
- Whitefish, MT
- NPI 1073362463
-
- Prosthetic/Orthotic Supplier
- Oklahoma City, OK
- NPI 1447834460
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709510400000",
"number": "1548460504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 110429",
"city": "AURORA",
"state": "CO",
"postal_code": "800420429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13123 E 16TH AVE",
"city": "AURORA",
"state": "CO",
"postal_code": "800457106",
"telephone_number": "720-777-1234"
}
],
"practiceLocations": [
{
"address_1": "310 Sunnyview Ln",
"address_purpose": "LOCATION",
"city": "Kalispell",
"state": "MT",
"postal_code": "599013129",
"country_code": "US",
"telephone_number": "406-751-5310",
"fax_number": "406-751-3068",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STIDHAM",
"first_name": "TIMOTHY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-18",
"last_updated": "2024-03-04",
"certification_date": "2024-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "MT",
"license": "59214",
"primary": false
},
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "NM",
"license": "MD2019-0698",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CO",
"license": "48502",
"primary": false
},
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "CO",
"license": "48502",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43622771",
"state": "CO"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "krmcmedicalrecords@krhdirect.org",
"affiliation": "Y",
"affiliationName": "Kalispell Regional Medical Center Inc",
"address_1": "310 Sunnyview Ln",
"city": "Kalispell",
"state": "MT",
"country_code": "US",
"postal_code": "599013129",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.