Kristin V Stahl, M.D

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

036100294 Issued in IL

Practice address

101 United Dr
Suite 110
Collinsville, IL 62234-7428

Phone

(618) 855-9041

Fax

(618) 855-9046

NPI assigned

Dec 6, 2006

Last updated

Apr 15, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 12

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristin.stahl@hp-il.direct.office.nextgen.com

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.

• Kristin Stahl MD PC

  dba Dale Avenue Pediatrics

  • Primary Care Clinic/Center
  • Collinsville, IL
  • NPI 1336209329

  Single Specialty

  NPD
• Granite City Clinic Corp

  dba Granite City Anesthesia

  • Certified Registered Nurse Anesthetist
  • Granite City, IL
  • NPI 1003892464
  NPD (past)
• Granite City Physicians Corp

  • Clinical Medical Laboratory
  • Granite City, IL
  • NPI 1508983214
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1942369145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 UNITED DR",
            "address_2": "SUITE 110",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622347428",
            "telephone_number": "618-855-9041",
            "fax_number": "618-855-9046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 UNITED DR",
            "address_2": "SUITE 110",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622347428",
            "telephone_number": "618-855-9041",
            "fax_number": "618-855-9046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAHL",
        "first_name": "KRISTIN",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036100294",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "IL",
            "license": "036100294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036100294-3",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI MEDICAID",
            "identifier": "205323819",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF ILLINOIS",
            "identifier": "6032067",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF ILLINOIS FEDERAL",
            "identifier": "6032067",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "PC19811",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT WEST",
            "identifier": "050558664",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP HMO",
            "identifier": "164815",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLIANCE CHOICE",
            "identifier": "6032067",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1202462",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP OPEN ACCESS",
            "identifier": "164815",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "412708",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7084003",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "HIE",
            "affiliation": "Y",
            "affiliationName": "St. Louis Children's Hospital",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "101 United Dr",
            "address_2": "Suite 110",
            "city": "Collinsville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622347428",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "HIE",
            "affiliation": "Y",
            "affiliationName": "St. Louis Children's Hospital",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7600 Dale Ave",
            "city": "Richmond Heights",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631172132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Susan M Smith, DC
• Southern Illinois Health Care Association
• Southern Illinois Healthcare Foundation Inc (SIHF Healthcare)
• Southern Illinois Healthcare Foundation, Inc. (Central Collinsville Health Center)
• St. John's Healing Community Board (St. John's Home & Community Care)
• Martina Renee Steed, CRNA
• Elizabeth Dawn Steele
• James J Stehman, D.M.D.
• Daniel Stephens, ATC
• Strader Rehabilitation and Consulting

• Pediatric Adolescent Medicine Physician in Collinsville, IL
• Providers in Collinsville, IL by specialty
• Pediatric Adolescent Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; 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.