Active NPI
Staci Lynn-Sargent MC Lean, PT
- Physical Therapist
- Santa Maria, CA
National Provider Identifier
1023049392
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT21074
- Practice address
- 2015B S Broadway
Santa Maria, CA 93454-7809 - Phone
- (805) 440-9318
- Fax
- (805) 938-5390
- NPI assigned
- Jul 5, 2006
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT21074 | CA | Primary |
Addresses
Primary practice location
2015B S Broadway
Santa Maria, CA 93454-7809
Mailing address
1106 Walnut St # 110
San Luis Obispo, CA 93401-2416
Phone (805) 788-0805
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT21074 | CA | MD | Physical Therapist |
| 21074 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Luis Physical Therapy & Orthopedic Rehabilitation Inc | Physical Therapist | Past | Accepting new patients |
| CV Physical Therapy, Inc. | Physical Therapist | Past | Accepting new patients |
| San Luis Physical Therapy & Orthopedic Rehabilitation Inc | Physical Therapist | Past | Accepting new patients |
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.
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- Physical Therapy Clinic/Center
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Physical Therapist
-
- Physical Therapy Clinic/Center
- Atascadero, CA
- NPI 1225046824
Physical Therapist
-
- Physical Therapy Clinic/Center
- Stockton, CA
- NPI 1578354239
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374796800000",
"number": "1023049392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1106 WALNUT ST # 110",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934012416",
"telephone_number": "805-788-0805",
"fax_number": "805-788-0845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2015B S BROADWAY",
"city": "SANTA MARIA",
"state": "CA",
"postal_code": "934547809",
"telephone_number": "805-440-9318",
"fax_number": "805-938-5390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MC LEAN",
"first_name": "STACI",
"middle_name": "LYNN-SARGENT",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-05",
"last_updated": "2013-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT21074",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Maria, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.