Stages of Life Medical Institute

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

ME 81513 Issued in FL

Legal business name

STAGES OF LIFE MEDICAL INSTITUTE

Practice address

1917 Boothe Cir
Longwood, FL 32750-6708

Phone

(407) 679-3337

NPI assigned

Dec 17, 2007

Last updated

Jun 12, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David S Klein, M.D.NPI 1215943360

Title

Physician

Phone

(407) 679-3337

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David S Klein, M.D.,FACA,FACPM

  • Pain Medicine (Anesthesiology) Physician
  • Longwood, FL
  • NPI 1215943360
  Medicare reassignment Authorized official
• Nathaniel Peter Krug, ARNP

  • Family Nurse Practitioner
  • Lake Mary, FL
  • NPI 1780159780
  Medicare reassignment NPD
• Justin Lindquist, M.D.

  • Neurology Physician
  • Orlando, FL
  • NPI 1457411944
  Medicare reassignment NPD
• Crystal Dejesus, PA-C

  • Physician Assistant
  • Mount Dora, FL
  • NPI 1063775765
  Medicare reassignment
• Kimberly Jean Luedecke, ARNP

  • Acute Care Nurse Practitioner
  • Longwood, FL
  • NPI 1386054559
  NPD (past)

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370995200000",
    "number": "1790968485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1917 BOOTHE CIRCLE",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327506708",
            "telephone_number": "407-679-3337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1917 BOOTHE CIR",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327506708",
            "telephone_number": "407-679-3337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAGES OF LIFE MEDICAL INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-17",
        "last_updated": "2013-06-12",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "407-679-3337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "FL",
            "license": "ME 81513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Jonathan Spitz, MSW
• Sheila M Spraggins
• Renee Christine Springer, PT
• Adam Sproat, DC
• Broderick Srodes
• Taylor Stagg, COTA/L
• Bonita Stamper
• Ella Staneszewski
• Alyssa Stanley
• State Medical Group Inc

• Pain Medicine (Anesthesiology) Physician in Longwood, FL
• Providers in Longwood, FL by specialty
• Pain Medicine (Anesthesiology) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; 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.