Active NPI
Edward Jordan Stoll Jr., M.D.
- Sports Medicine (Orthopaedic Surgery) Physician
- Wheat Ridge, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Orthopaedic Surgery) Physician
- License
- 30560
- Practice address
- 3455 Lutheran Pkwy Ste 105
Wheat Ridge, CO 80033-6028 - Phone
- (303) 665-2603
- Fax
- (303) 665-2605
- NPI assigned
- Aug 11, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | 30560 | CO | Primary |
Addresses
Primary practice location
3455 Lutheran Pkwy Ste 105
Wheat Ridge, CO 80033-6028
Mailing address
3455 Lutheran Pkwy
Ste 105
Wheat Ridge, CO 80033-6028
Phone (303) 665-2603
Other practice location 1
500 W 144th Ave Ste 230
Westminster, CO 80023-9328
Phone (303) 665-2603 ext. 223
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01305606 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30560 | CO | MD | Sports Medicine (Orthopaedic Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopedic Centers of Colorado, LLC | Sports Medicine | Current | Accepting new patients |
| Orthopedic Centers of Colorado, LLC | Sports Medicine | Current | Accepting new patients |
| Orthopedic Professional Association P.C. | Past | Accepting new patients |
Locations
1411 S Potomac St
Ste 350
Aurora, CO 80012
Phone (303) 671-2134
8101 E Lowry Blvd
Ste 120
Lowry, CO 80230
Phone (303) 806-1998
500 W 144th Ave
Ste 230
Westminster, CO 80023
Phone 3036652603 ext. 223
3455 Lutheran Pkwy
Ste 210
Wheat Ridge, CO 80033
Phone (303) 403-6580
3455 Lutheran Pkwy
Ste 105
Wheat Ridge, CO 80033
Phone (303) 456-6000
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Denver, CO
- NPI 1801339502
Sports Medicine
-
- Orthopaedic Surgery Physician
- Superior, CO
- NPI 1336870856
Sports Medicine
-
- Orthopaedic Surgery Physician
- Louisville, CO
- NPI 1922738228
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1841201217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3455 LUTHERAN PKWY",
"address_2": "STE 105",
"city": "WHEAT RIDGE",
"state": "CO",
"postal_code": "800336028",
"telephone_number": "303-665-2603",
"fax_number": "303-665-2605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3455 LUTHERAN PKWY STE 105",
"city": "WHEAT RIDGE",
"state": "CO",
"postal_code": "800336028",
"telephone_number": "303-665-2603",
"fax_number": "303-665-2605"
}
],
"practiceLocations": [
{
"address_1": "500 W 144th Ave Ste 230",
"address_purpose": "LOCATION",
"city": "Westminster",
"state": "CO",
"postal_code": "800239328",
"country_code": "US",
"telephone_number": "303-665-2603 x223",
"fax_number": "303-665-2605",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STOLL",
"first_name": "EDWARD",
"middle_name": "JORDAN",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-11",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "CO",
"license": "30560",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01305606",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wheat Ridge, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.