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

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

Other identifiers 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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• 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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2381462",
            "state": "OH"
        }
    ],
    "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 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.