Stacey S Goodale, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT13044 Issued in FL

Practice address

2970 University Pkwy Ste 105
Sarasota, FL 34243-2401

Phone

(941) 360-1988

Fax

(941) 360-1998

NPI assigned

Dec 19, 2012

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 identifiers 1

Other names 1

• Stacey Kay Sheppard Former name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Maxider CorporationGroup PAC ID 4385619154, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22410/brand/1/csg/1/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.

• Maxider Corporation

  • Physical Therapist
  • Sarasota, FL
  • NPI 1669501615

  FL, Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1355875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1063758019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2970 UNIVERSITY PKWY STE 105",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342432401",
            "telephone_number": "941-360-1988",
            "fax_number": "941-360-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2970 UNIVERSITY PKWY STE 105",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342432401",
            "telephone_number": "941-360-1988",
            "fax_number": "941-360-1998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "943 S Beneva Rd",
            "address_2": "Suite 204",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342322476",
            "country_code": "US",
            "telephone_number": "941-955-1850",
            "fax_number": "941-955-1852",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODALE",
        "first_name": "STACEY",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-19",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT13044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BC/BS",
            "identifier": "Y0F56",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "SHEPPARD",
            "middle_name": "KAY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Good Business LLC
• Shirley A Good, PH.D.
• Virginia Johnson Good, MD
• Tamara Goodacre, LCSW
• McKaleigh B Goodale, PT
• Gillian Goodhue, LMHC
• Carol Alice Goodkin, MA, RDT,LCAT
• Jason Lloyd Goodloe, MD
• Courtney Goodman
• Jerry A Goodman, MD

• All providers in Sarasota, FL
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.