Stefanie Ruth Flynn

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OC010323 Issued in PA

Practice address

900 Willow Valley Lakes Drive
Willow Street, PA 17584

Phone

(717) 464-6861

NPI assigned

May 17, 2007

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

Enrolled in PA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Functional Freedom LLC

  • Occupational Therapist
  • Lancaster, PA
  • NPI 1861989493
  Medicare reassignment NPD

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197417600000",
    "number": "1063629004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 COUNTRY HILL DRIVE",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "17111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WILLOW VALLEY LAKES DRIVE",
            "city": "WILLOW STREET",
            "state": "PA",
            "postal_code": "17584",
            "telephone_number": "717-464-6861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "STEFANIE",
        "middle_name": "RUTH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC010323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kamal A. Elliot, AU.D.
• Eric W. Howard DMD, PC
• Melanie Marie Falgout, M.D.
• Kent V Flinchbaugh, DPM
• Mary Florida, RN
• Judith Ann Foster
• Richard P Frey, DO
• Lawrence M George, LSW
• Marina Gonzalez, MD
• Tama Goodman, LSW

• Occupational Therapist in Willow Street, PA
• Providers in Willow Street, PA by specialty
• Occupational Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.