Laci Marie Stivison, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA.011722 Issued in OH

Practice address

16459 Angle Rd
Logan, OH 43138-9790

Phone

(740) 603-8860

NPI assigned

Sep 27, 2019

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1033760350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 E MAPLE ST",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447202593",
            "telephone_number": "330-498-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16459 ANGLE RD",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "431389790",
            "telephone_number": "740-603-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIVISON",
        "first_name": "LACI",
        "middle_name": "MARIE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-27",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "PTA.011722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melody Dawn Spicer, LMT
• Amy Standall, QMHS
• Brooke Stanley, ED.S.
• Joshua Stanton, RPH
• Brian L Still, D.O.
• Sierra Storms
• Lia Storts, PHARMD, RPH
• Jennifer Sue Strickland, R.N.
• Michaelia C Strohl
• Summit Recovery LLC

• Physical Therapy Assistant in Logan, OH
• Providers in Logan, OH by specialty
• Physical Therapy Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; 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.