Stacey Brooke Spoon, PT, DPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

1264605 Issued in TX

Practice address

1013 S Wells St
Edna, TX 77957-4045

Phone

(361) 782-7898

Fax

(361) 782-6317

NPI assigned

Aug 17, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Stacey Brooke Potter Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Gulf Coast Rehabilitation, PC

  dba Excel Sports Therapy

  • Physical Therapist
  • Victoria, TX
  • NPI 1952349631
  NPD

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749168000000",
    "number": "1033585773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3666",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779033666",
            "telephone_number": "361-782-7898",
            "fax_number": "361-782-6317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 S WELLS ST",
            "city": "EDNA",
            "state": "TX",
            "postal_code": "779574045",
            "telephone_number": "361-782-7898",
            "fax_number": "361-782-6317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPOON",
        "first_name": "STACEY",
        "middle_name": "BROOKE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-17",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "TX",
            "license": "1264605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "POTTER",
            "middle_name": "BROOKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jose Antonio Sanchez, PHARMD
• Select Physical Therapy Holdings Inc
• Dawn Sheblak
• Elizabeth Sommerfeld, M.S., R.D., L.D.
• Southbrooke Manor Nursing and Rehabilitation Center, Inc (Southbrooke Manor Nursing and Rehabilitation Center)
• Justine N Strelczyk, FNP-C
• Sunshine Play Therapy and Counseling
• Total Renal Care Texas Limited Partnership (Edna Dialysis Center)
• Rachel Turner, LPC
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-0474)

• Pediatric Physical Therapist in Edna, TX
• Providers in Edna, TX by specialty
• Pediatric Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.