Shane Michael Stadtmueller, DC, MS, ATC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

013177 Issued in NY

Practice address

5820 Main St. Suite 201
Williamsville, NY 14221

Phone

(716) 634-2587

NPI assigned

Nov 27, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Opc Buffalo LLC

  • Chiropractor
  • Williamsville, NY
  • NPI 1376185595
  NPD (past)

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

{
    "created_epoch": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1902376536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5820 MAIN ST. SUITE 201",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "14221",
            "telephone_number": "716-634-2587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5820 MAIN ST. SUITE 201",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "14221",
            "telephone_number": "716-634-2587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STADTMUELLER",
        "first_name": "SHANE",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DC, MS, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-27",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "NY",
            "license": "013177",
            "primary": false
        },
        {
            "code": "111NX0100X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Occupational Health",
            "state": "NY",
            "license": "013177",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NY",
            "license": "013177",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "013177",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea M St. Laurent, LMHC
• Sarah G Stabler, LMT, NCTMB
• Stacey L. Donahue, LCSW, PLLC
• Debra Stacey, MSNE PMHNP ANP CDE
• Catherine C Stack, CNM
• Kerri Ann Staffeldt, RPH
• Taylor Stahl, RN
• Renay Staley, LPN
• Scott Andrew Stambach, PA
• Troy Stancampiano, DC

• Sports Physician Chiropractor in Williamsville, NY
• Providers in Williamsville, NY by specialty
• Sports Physician Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2018; 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.