Shane Thomas Stockelman, ATC, LAT

Primary specialty

Sports Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0010X

License

5752 Issued in FL

Practice address

3334 Capital Medical Blvd
Tallahassee, FL 32308-8405

Phone

(850) 877-8174

NPI assigned

Feb 11, 2020

Last updated

Feb 11, 2020By the provider in NPPES

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

State licenses

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

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1932731684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 N MERIDIAN RD APT 128",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323035658",
            "telephone_number": "954-650-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3334 CAPITAL MEDICAL BLVD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323088405",
            "telephone_number": "850-877-8174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKELMAN",
        "first_name": "SHANE",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-11",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "FL",
            "license": "5752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Stimel, PH.D.
• Curtis Clarke Stine, MD
• Jennifer Stinson
• Brittany McKinney Stitely, M.ED. CCC-SLP
• Andrew Stivers
• Stockwell Reisman Paulk & Taylor PA (Digestive Disease Clinic)
• James William Stockwell, M. D.
• Ralph Spencer Stoetzel III, M.D.
• Donald Stokes, C-RT(R)
• Symone M Stokes, COTA/L

• Sports Medicine (Internal Medicine) Physician in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Sports Medicine (Internal Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; 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.