Individual provider Active NPI

Taylor Stoecklin, DC

  • Chiropractor
  • Boulder, CO
National Provider Identifier
1750809638
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0007555 Issued in CO
Practice address
1113 Spruce St Ste 401a
Boulder, CO 80302-4001
Phone
(720) 583-6621
NPI assigned
Aug 31, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0007555 CO Primary

Addresses

Primary practice location

1113 Spruce St Ste 401a
Boulder, CO 80302-4001

Mailing address

1113 Spruce St Ste 401a
Boulder, CO 80302-4001
Phone (720) 583-6621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211117001370 AK Practitioner - Chiropractic 5799174504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

177 E Bunnell Ave
Suite 2
Homer, AK 99603-7854
Phone (907) 235-7221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0007555COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Arctic Chiropractic Homer Chiropractor CurrentSince Oct 20, 2021 Accepting new patients
Hediger Chiropractic Clinic Chiropractor PastSince Oct 20, 2021 Accepting new patients
Arctic Rehabilitation and Physical Therapy Homer PastSince Mar 1, 2022 Accepting new patients

Locations

177 E Bunnell Ave
Ste 2
Homer, AK 99603
Phone (907) 235-7221

1150 S Colony Way
Ste 3
Palmer, AK 99645

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1750809638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 SPRUCE ST STE 401A",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803024001",
            "telephone_number": "720-583-6621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 SPRUCE ST STE 401A",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803024001",
            "telephone_number": "720-583-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOECKLIN",
        "first_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "0007555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.