Active NPI
Kevin Stoltz, AU.D.
- Audiologist
- Savage, MN
National Provider Identifier
1639418759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 8355
- Practice address
- 6001 Egan Dr
Suite 160
Savage, MN 55378-4921 - Phone
- (612) 564-5686
- NPI assigned
- Feb 8, 2013
- Last updated
- Feb 8, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 8355 | MN | Primary |
Addresses
Primary practice location
6001 Egan Dr
Suite 160
Savage, MN 55378-4921
Mailing address
4105 Deerwood TRL
Eagan, MN 55122-1887
Phone (612) 308-6761
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8355 | MN | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360281600000",
"number": "1639418759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4105 DEERWOOD TRL",
"city": "EAGAN",
"state": "MN",
"postal_code": "551221887",
"telephone_number": "612-308-6761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6001 EGAN DR",
"address_2": "SUITE 160",
"city": "SAVAGE",
"state": "MN",
"postal_code": "553784921",
"telephone_number": "612-564-5686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOLTZ",
"first_name": "KEVIN",
"name_prefix": "Dr.",
"credential": "AU.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-02-08",
"last_updated": "2013-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MN",
"license": "8355",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Savage, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.