Stillwater Center

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

MRDD25992 Issued in OH

Legal business name

STILLWATER CENTER

Practice address

8100 N Main St
Dayton, OH 45415-1702

Phone

(937) 890-0646

Fax

(937) 890-9579

NPI assigned

Feb 16, 2007

Last updated

Oct 20, 2009By 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

Ms. Sue L Curtis

Title

Director

Phone

(937) 890-0646

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801930748. Details of each certification follow.

• CCN 36G584 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 36G584

Legal name

STILLWATER CENTER

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Mar 11, 2003

Last certification

Sep 22, 2025

Beds

98

Ownership / control type

County

Facility address

8100 North Main Street
Dayton, OH 45415

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

CLIA laboratory certificates

Practitioners 1

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.

• Mark Arden Boettler, M.D.

  • Internal Medicine Physician
  • Dayton, OH
  • NPI 1124052212
  NPD (past)

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255996800000",
    "number": "1801930748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 N MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454151702",
            "telephone_number": "937-890-0646",
            "fax_number": "937-890-9579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 N MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454151702",
            "telephone_number": "937-890-0646",
            "fax_number": "937-890-9579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILLWATER CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2009-10-20",
        "status": "A",
        "authorized_official_last_name": "CURTIS",
        "authorized_official_first_name": "SUE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "937-890-0646",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "OH",
            "license": "MRDD25992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Stidham, DEM
• Kelly Nicole Stiffler, PA
• Lisa Stiles
• Ashley M. Still
• Korey Stills
• Joseph Austin Stimler, DPT
• David Morris Stine, O.D.
• Payton Stinnett
• Jaclyn D Stinson, LPN
• Tiffany Rose Stinson

• Intellectual Disabilities Intermediate Care Facility in Dayton, OH
• Providers in Dayton, OH by specialty
• Intellectual Disabilities Intermediate Care Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.