Active NPI
Stanford Mark Steketee, D.C.
- Chiropractor
- Boulder, MT
National Provider Identifier
1790833085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1008
- Practice address
- 104 South Main Street
Boulder, MT 59632-0566 - Phone
- (406) 225-3111
- Fax
- (406) 225-3444
- NPI assigned
- Jan 5, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1008 | MT | Primary |
Addresses
Primary practice location
104 South Main Street
Boulder, MT 59632-0566
Mailing address
PO Box 566
104 South Main Street
Boulder, MT 59632-0566
Phone (406) 225-3111
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000040723 | Other | MT | BLUE CROSS BLUE SHIELD |
| 0000164322 | Medicaid | MT | |
| 81039 | Other | MT | EBMS |
Other names 1
- S. Mark Steketee
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1008 | MT | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ottawa Chiropractic PLLC | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
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.
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- NPI 1366510240
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790833085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 566",
"address_2": "104 SOUTH MAIN STREET",
"city": "BOULDER",
"state": "MT",
"postal_code": "596320566",
"telephone_number": "406-225-3111",
"fax_number": "406-225-3444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 SOUTH MAIN STREET",
"city": "BOULDER",
"state": "MT",
"postal_code": "596320566",
"telephone_number": "406-225-3111",
"fax_number": "406-225-3444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEKETEE",
"first_name": "STANFORD",
"middle_name": "MARK",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MT",
"license": "1008",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0000040723",
"state": "MT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0000164322",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EBMS",
"identifier": "81039",
"state": "MT"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "S.",
"last_name": "STEKETEE",
"middle_name": "MARK",
"credential": "D.C.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Boulder, MT
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.