Tyler Alan Stahlman, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2019035711 Issued in MO

Practice address

832 Horan Dr
Fenton, MO 63026-2408

Phone

(636) 305-6490

NPI assigned

Feb 10, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Fenton Chiropractic and Rehab Center, Inc

  • Chiropractor
  • Fenton, MO
  • NPI 1922121912
  NPD (past)

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1730711409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8403 FAWN HILL LN",
            "city": "HOUSE SPRINGS",
            "state": "MO",
            "postal_code": "630513208",
            "telephone_number": "636-751-9937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "832 HORAN DR",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262408",
            "telephone_number": "636-305-6490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAHLMAN",
        "first_name": "TYLER",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2019035711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Louis Spine and Joint Pain Specialists LLC
• St. Anthony'S Physician Organization
• St. Anthony'S Physician Organization
• St. Anthony'S Physician Organization
• St. Louis Dry Needling and Physical Therapy
• Tonisha Stallings
• Kori A Stechmesser, CRNA
• Brian Matthew Stegmann, D.D.S.
• Melissa K Stein, DO
• Ellen Marie Stevenson

• All providers in Fenton, MO
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; 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.