Stone Bluff Medical, LLC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

STONE BLUFF MEDICAL, LLC

Practice address

2028 Mahaney Ave
Tahlequah, OK 74464-5783

Phone

(918) 992-6050

Fax

(833) 763-2349

NPI assigned

Jul 15, 2026

Organization subpart

No

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

Authorized official

Name

Ian Kelley

Title

Sole Member

Phone

(918) 633-0447

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1784073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784073600000",
    "number": "1942129663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2028 MAHANEY AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744645783",
            "telephone_number": "918-992-6050",
            "fax_number": "833-763-2349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2028 MAHANEY AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744645783",
            "telephone_number": "918-992-6050",
            "fax_number": "833-763-2349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONE BLUFF MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-15",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "IAN",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "918-633-0447"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan Dale Steely, MASTERS
• Alexander J. Stephenson
• Ida Rebecca Stephenson, CNM
• Michelle Stephenson
• Amber Stewart, MS, LPC
• James Stone
• Jake Andrew Stopp
• Ellis Stout
• Nichole Stout, MSCCCSLP
• Richard Alan Stowe, PHARMD

• Pain Medicine Physician in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Pain Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; 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.