Organization Active NPI

William M Stinson MD Medical Corp

  • Family Medicine Physician
  • Anderson, IN
National Provider Identifier
1639353949
Registry record updated Apr 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01032850 Issued in IN
Legal business name
WILLIAM M STINSON MD MEDICAL CORP
Practice address
2101 Jackson St
Suite 101
Anderson, IN 46016-4386
Phone
(765) 646-8479
Fax
(765) 646-8526
NPI assigned
Dec 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2008

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

Authorized official

Name
David Mark Stinson, M.D.
Title
President/Provider
Phone
(765) 646-8479

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 01032850 IN Primary

Addresses

Primary practice location

2101 Jackson St
Suite 101
Anderson, IN 46016-4386

Mailing address

2101 Jackson St
Suite 101
Anderson, IN 46016-4386
Phone (765) 646-8479

Other identifiers 1

IdentifierTypeStateIssuer
000000100998OtherINANTHEM BLUE CROSS

National Provider Directory

National Provider Directory

Locations

2101 Jackson St
Ste 101
Anderson, IN 46016
Phone (765) 609-6063

NPI Registry JSON

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

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207180800000",
    "number": "1639353949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 JACKSON ST",
            "address_2": "SUITE 101",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460164386",
            "telephone_number": "765-646-8479",
            "fax_number": "765-646-8526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 JACKSON ST",
            "address_2": "SUITE 101",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460164386",
            "telephone_number": "765-646-8479",
            "fax_number": "765-646-8526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM M STINSON MD MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-21",
        "last_updated": "2008-04-03",
        "status": "A",
        "authorized_official_last_name": "STINSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT/PROVIDER",
        "authorized_official_telephone_number": "765-646-8479",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01032850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "000000100998",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2008; 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.