Stillwater Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

STILLWATER MEDICAL GROUP

Doing business as

Stillwater Medical Group Mahtomedi

Practice address

700 Wildwood Rd
Saint Paul, MN 55115-1852

Phone

(651) 439-1234

Fax

(651) 275-3325

NPI assigned

Sep 17, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Ross Bullard

Title

Director of Finance

Phone

(651) 439-1234

Specialties & licenses 3

Addresses

Other names 1

• Stillwater Medical Group Mahtomedi Doing business as

Locations

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375056000000",
    "number": "1861742918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 CURVE CREST BLVD",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826040",
            "telephone_number": "651-439-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 WILDWOOD RD",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551151852",
            "telephone_number": "651-439-1234",
            "fax_number": "651-275-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILLWATER MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-17",
        "last_updated": "2013-07-29",
        "status": "A",
        "authorized_official_last_name": "BULLARD",
        "authorized_official_first_name": "ROSS",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "651-439-1234",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stillwater Medical Group Mahtomedi",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andrew James Stiehm, MD
• Ashley Jo Stiles, ATR
• Matthew Stiles
• Lauren Stille, RD
• Stacey Lynn Stillmunkes, MA, LMFT
• Patricia A Stinchfield, CPNP
• Maria Ramos Stitzel, MD
• Lindsey Stiyer, RD
• Sharon Irene Stocker, CRNA
• Tacy Stocking, RN

• Family Medicine Physician in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.