Individual provider Active NPI

Craig Anthony Stoller, DC

  • Chiropractor
  • Ann Arbor, MI
National Provider Identifier
1770593733
Registry record updated Nov 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
L567685 Issued in MI
Practice address
2464E Stadium Blvd
Ann Arbor, MI 48104-4813
Phone
(734) 418-7515
NPI assigned
Aug 9, 2006
Last updated
Nov 24, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X L567685 MI Primary

Addresses

Primary practice location

2464E Stadium Blvd
Ann Arbor, MI 48104-4813

Mailing address

203 S Zeeb Rd Ste 106
Ann Arbor, MI 48103-8324
Phone (734) 274-5107

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060417000058 MI Practitioner - Chiropractic 3678582806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1955 Pauline Blvd
Suite 80
Ann Arbor, MI 48103-5003
Phone (248) 709-9446

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L567685MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Align Chiropractic Center, PLLC Chiropractor CurrentSince Jan 11, 2016 Accepting new patients
Stoller Clinic PC Dba the Lowen Clinic Chiropractor PastSince Mar 1, 2006 Accepting new patients
Vizuri Health Center PC Chiropractor PastSince Jan 1, 2009 Accepting new patients

Locations

1955 Pauline Blvd
Ste 80
Ann Arbor, MI 48103
Phone (248) 709-9446

2464 E Stadium Blvd
Ann Arbor, MI 48104
Phone (734) 418-7515

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448323200000",
    "number": "1770593733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S ZEEB RD STE 106",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481038324",
            "telephone_number": "734-274-5107",
            "fax_number": "734-661-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2464E STADIUM BLVD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044813",
            "telephone_number": "734-418-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLLER",
        "first_name": "CRAIG",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2015-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "L567685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2015; 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.