Active NPI
Stephan Arthur Siele, DC
- Nutrition Chiropractor
- Ketchum, ID
National Provider Identifier
1831775733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Chiropractor
- License
- CHIA869
- Practice address
- 200 W River St
Suite 302
Ketchum, ID 83340 - Phone
- (208) 622-9400
- NPI assigned
- Mar 22, 2021
- 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 |
|---|---|---|---|---|
| Nutrition Chiropractor | 111NN1001X | CHIA869 | ID | Primary |
Addresses
Primary practice location
200 W River St
Suite 302
Ketchum, ID 83340
Mailing address
PO Box 6353
Ketchum, ID 83340-6353
Phone (208) 622-9400
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIA869 | ID | MD | Nutrition Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616371200000",
"number": "1831775733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6353",
"city": "KETCHUM",
"state": "ID",
"postal_code": "833406353",
"telephone_number": "208-622-9400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 W RIVER ST",
"address_2": "SUITE 302",
"city": "KETCHUM",
"state": "ID",
"postal_code": "83340",
"telephone_number": "208-622-9400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIELE",
"first_name": "STEPHAN",
"middle_name": "ARTHUR",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-03-22",
"last_updated": "2021-03-22",
"certification_date": "2021-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "111NN1001X",
"taxonomy_group": "",
"desc": "Chiropractor, Nutrition",
"state": "ID",
"license": "CHIA869",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ketchum, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.