Robert C Stidham II

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT2257 Issued in AZ

Practice address

2919 S Ellsworth Rd
Suite 111
Mesa, AZ 85212-2164

Phone

(704) 831-5065

NPI assigned

Aug 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Rehab Arizona Neuro Rehabilitation, LLC

  • Rehabilitation Clinic/Center
  • Mesa, AZ
  • NPI 1851359145
  NPD (past)

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

{
    "created_epoch": "1187481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1013100577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 WATER RIDGE PKWY",
            "address_2": "SUITE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282174580",
            "telephone_number": "704-831-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919 S ELLSWORTH RD",
            "address_2": "SUITE 111",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852122164",
            "telephone_number": "704-831-5065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIDHAM",
        "first_name": "ROBERT",
        "middle_name": "C",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-19",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "OT2257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "117502",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Candice Stewart, SLP-A
• Daija Stewart
• Grace Elma Stewart, M.D.
• Kristine Mallanao Stewart
• Liliana B Stewart, PHARMD
• Donald Chase Stiers
• Darleisha Renee Stigall
• Michelle Lynn Stillings, PT, DPT
• Stillpoint Wellness, LLC
• Stillwater Counseling Associates, PLLC

• Occupational Therapist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Occupational Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; 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.