Active NPI
Evan Stoecker, MS, RDN
- Registered Dietitian
- Broomfield, CO
National Provider Identifier
1780208819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86109766
- Practice address
- 469 Co-7
Broomfield, CO 80023 - Phone
- (720) 478-5000
- NPI assigned
- Jun 4, 2020
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86109766 | Primary |
Addresses
Primary practice location
469 Co-7
Broomfield, CO 80023
Mailing address
3521 N Marion St
Denver, CO 80205-3956
Phone (760) 688-6090
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
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591228800000",
"number": "1780208819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3521 N MARION ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802053956",
"telephone_number": "760-688-6090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "469 CO-7",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "80023",
"telephone_number": "720-478-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOECKER",
"first_name": "EVAN",
"credential": "MS, RDN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-06-04",
"last_updated": "2020-06-04",
"certification_date": "2020-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": "86109766",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broomfield, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.