Gary K Stoltz, D.C., P.a.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH2081 Issued in FL

Legal business name

GARY K STOLTZ, D.C., P.A.

Practice address

2105 Prevatt St
Eustis, FL 32726-6131

Phone

(352) 357-7955

Fax

(352) 357-7254

NPI assigned

Nov 9, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Gary Kent Stoltz, DCNPI 1316925084

Title

Owner

Phone

(352) 357-7955

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gary Kent Stoltz, DC

  • Chiropractor
  • Eustis, FL
  • NPI 1316925084
  Medicare reassignment NPD Authorized official
• Bryan Kent Stoltz, D.C.

  • Chiropractor
  • Eustis, FL
  • NPI 1063770584
  Medicare reassignment NPD

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

{
    "created_epoch": "1320796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320796800000",
    "number": "1609153311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 PREVATT ST",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327266131",
            "telephone_number": "352-357-7955",
            "fax_number": "352-357-7254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 PREVATT ST",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327266131",
            "telephone_number": "352-357-7955",
            "fax_number": "352-357-7254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY K STOLTZ, D.C., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-09",
        "last_updated": "2011-11-09",
        "status": "A",
        "authorized_official_last_name": "STOLTZ",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "KENT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-357-7955",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH2081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "350907427",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE ID- WORK COMP",
            "identifier": "CH2081",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380263900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sandra Gatrell, M.A., BCBA
• Kenneth Charles Gatson, O.D.
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• Chiropractor in Eustis, FL
• Providers in Eustis, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.