Active NPI
Walter Scott Stine, M.D.
- Family Medicine Physician
- Carrollton, OH
National Provider Identifier
1700896016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 053573
- Practice address
- 1020 Trump Rd NW
Carrollton, OH 44615-8422 - Phone
- (330) 627-7055
- Fax
- (330) 627-7602
- NPI assigned
- Aug 9, 2006
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 053573 | OH | Primary |
Addresses
Primary practice location
1020 Trump Rd NW
Carrollton, OH 44615-8422
Mailing address
1020 Trump Rd NW
P.O. Box 38
Carrollton, OH 44615-8422
Phone (330) 627-7055
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0634513 | Medicaid | OH |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 053573 | OH | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700896016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 TRUMP RD NW",
"address_2": "P.O. BOX 38",
"city": "CARROLLTON",
"state": "OH",
"postal_code": "446158422",
"telephone_number": "330-627-7055",
"fax_number": "330-627-7602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 TRUMP RD NW",
"city": "CARROLLTON",
"state": "OH",
"postal_code": "446158422",
"telephone_number": "330-627-7055",
"fax_number": "330-627-7602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STINE",
"first_name": "WALTER",
"middle_name": "SCOTT",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "053573",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0634513",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carrollton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.