David L Stahlecker

Primary specialty

Lodging ProviderTaxonomy code 177F00000X

Practice address

629 N Harrison Ave
Pocatello, ID 83204-2935

Phone

(208) 232-9468

NPI assigned

Sep 26, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Neighborworks Pocatello

  • Lodging Provider
  • Pocatello, ID
  • NPI 1346077872
  NPD Authorized official

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

{
    "created_epoch": "1727308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1871310102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 N ARTHUR AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832043104",
            "telephone_number": "208-232-9468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 N HARRISON AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832042935",
            "telephone_number": "208-232-9468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAHLECKER",
        "first_name": "DAVID",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-26",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elisabeth Mae Spraggins, APRN-FNP
• Laura M Sprague, DPT
• Daniel A Spurlock, PHARMD, R.PH
• Tawny Alice Spurlock, PA-C
• Rulon Ephraim Squire, PHARMD
• Brittany Ana Stalzer
• Matthew S Stanger, MOTR/L
• Shelbie Stanger, PTA
• Christine Stanislowski
• State of Idaho

• Lodging Provider in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Lodging Provider in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.