Carly Ann Stillman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PENDING Issued in CO

Practice address

350 Market St Unit 316
Basalt, CO 81621-7405

Phone

(970) 927-1141

Fax

(970) 422-7123

NPI assigned

Oct 31, 2017

Last updated

Oct 31, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Roaring Fork Neurology, P.C.

  dba Bluebird Neurology

  • Neurology Physician
  • Basalt, CO
  • NPI 1417279597
  Medicare reassignment

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

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509408000000",
    "number": "1891207775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 JB CT",
            "city": "GLENWOOD SPGS",
            "state": "CO",
            "postal_code": "816018733",
            "telephone_number": "970-379-1775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 MARKET ST UNIT 316",
            "city": "BASALT",
            "state": "CO",
            "postal_code": "816217405",
            "telephone_number": "970-927-1141",
            "fax_number": "970-422-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILLMAN",
        "first_name": "CARLY",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-31",
        "last_updated": "2017-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sopris Medical Practice, P.C.
• Sopris Rehabilitation Services
• Jillian Standley, MA, LPCC
• Steadman Clinic Professional LLC (The Steadman Clinic)
• Karen Chrisholm Stevenson, PHYSICAL THERAPIST
• Heidi C Stoeckl, L.AC.
• T J Bauer OD PC (Bauer Eye Care PC)
• Kevin Tadus
• Maria Lynn Tafuri, LMFT
• Scott J. Tesoro, D.C.

• Physician Assistant in Basalt, CO
• Providers in Basalt, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2017; 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.

Verify at the official NPI Registry.