Individual provider Active NPI

Christopher Robert Stull, D.C.

  • Chiropractor
  • Broomfield, CO
National Provider Identifier
1568699759
Registry record updated Jun 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6377 Issued in CO
Practice address
12995 Sheridan Blvd
#101
Broomfield, CO 80020-1480
Phone
(563) 505-1731
NPI assigned
Jun 16, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6377 CO Primary

Addresses

Primary practice location

12995 Sheridan Blvd
#101
Broomfield, CO 80020-1480

Mailing address

12995 Sheridan Blvd
#101
Broomfield, CO 80020-1480
Phone (563) 505-1731

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130419000096 CO Practitioner - Chiropractic 3375789241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12995 Sheridan Blvd
Suite 101
Broomfield, CO 80020-1488
Phone (303) 466-3988

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6377COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher R Stull D.C.P.C. Chiropractor CurrentSince Jan 13, 2013 Accepting new patients

Locations

12995 Sheridan Blvd
Ste 101
Broomfield, CO 80020
Phone (303) 466-3988

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245110400000",
    "number": "1568699759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12995 SHERIDAN BLVD",
            "address_2": "#101",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800201480",
            "telephone_number": "563-505-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12995 SHERIDAN BLVD",
            "address_2": "#101",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800201480",
            "telephone_number": "563-505-1731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STULL",
        "first_name": "CHRISTOPHER",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-16",
        "last_updated": "2009-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "6377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.