NPIMap

Individual provider Active NPI

Tracy L West-Stallard, OTR/L, HTC, PAM

  • Physical Rehabilitation Occupational Therapist
  • Bishop, CA
National Provider Identifier
1013020973
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
2814 Issued in CA
Practice address
162 S Main St
Bishop, CA 93514-3415
Phone
(760) 872-2942
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2814 CA
Physical Rehabilitation Occupational Therapist 225XP0019X 2814 CA Primary

Addresses

Primary practice location

162 S Main St
Bishop, CA 93514-3415

Mailing address

85 Sierra Park Rd
Mammoth Lakes, CA 93546-2073
Phone (760) 934-3311

Other practice location 1

5 Pinecone Drive
Suite 100
Dayton, NV 89403
Phone (775) 246-7742

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mahotwest@mammoth.cernerdirect.com Direct

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Mono Healthcare District PastSince Feb 14, 2021 Accepting new patients
Therapy West LLC Past Accepting new patients
High Desert Therapists, Inc Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/89b7757a-432f-4f56-8638-86920235f2d0/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1013020973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 SIERRA PARK RD",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "935462073",
            "telephone_number": "760-934-3311",
            "fax_number": "775-883-7742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 S MAIN ST",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935143415",
            "telephone_number": "760-872-2942"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Pinecone Drive",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "NV",
            "postal_code": "89403",
            "country_code": "US",
            "telephone_number": "775-246-7742",
            "fax_number": "775-883-7742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEST-STALLARD",
        "first_name": "TRACY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "OTR/L, HTC, PAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "2814",
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "CA",
            "license": "2814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mahotwest@mammoth.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Mammoth Hospital Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "85 Sierra Park Rd",
            "city": "Mammoth Lakes",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935462073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bishop, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; 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.