Stuart H Ackley, MD
Individual provider Active NPI Surgery Physician · Grand Junction, CO
NPI 1821001033 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1821001033
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- 31377 (CO)
- Practice address
- 1001 Wellington Ave
Grand Junction, CO 81501-8122 - Phone
- (970) 243-0900
- NPI assigned
- Aug 15, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31377 | CO | MD | Surgery Physician |
Interoperability endpoints
- stuartackley@gswc.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 31377 | CO | Yes |
Addresses
Primary practice location
1001 Wellington Ave
Grand Junction, CO 81501-8122
Mailing address
2440 N 11TH St
Grand Junction, CO 81501-8102
Phone (970) 243-0900
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01313774 | Medicaid | CO |
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All providers in Grand Junction, CO · Surgery Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.