Active NPI
Staci Worm, MOT, OTR/L
- Occupational Medicine Physician
- David City, NE
National Provider Identifier
1003285909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Medicine Physician
- License
- 1932
- Practice address
- 372 S 9TH St
David City, NE 68632-2116 - Phone
- (402) 367-1200
- Fax
- (855) 681-9015
- NPI assigned
- Sep 21, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Medicine Physician | 2083X0100X | 1932 | NE | Primary |
Addresses
Primary practice location
372 S 9TH St
David City, NE 68632-2116
Mailing address
456 N 8TH St
David City, NE 68632-1708
Phone (402) 641-1501
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932 | Other | NE | OCCUPATIONAL THERAPIST |
Other names 1
- Staci Ossian
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1932 | NE | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442793600000",
"number": "1003285909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "456 N 8TH ST",
"city": "DAVID CITY",
"state": "NE",
"postal_code": "686321708",
"telephone_number": "402-641-1501",
"fax_number": "855-681-9015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "372 S 9TH ST",
"city": "DAVID CITY",
"state": "NE",
"postal_code": "686322116",
"telephone_number": "402-367-1200",
"fax_number": "855-681-9015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WORM",
"first_name": "STACI",
"credential": "MOT, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-21",
"last_updated": "2015-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "NE",
"license": "1932",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OCCUPATIONAL THERAPIST",
"identifier": "1932",
"state": "NE"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "STACI",
"last_name": "OSSIAN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in David City, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.