Active NPI
Stacey L Ross, ASSOCIATES DEGREE
- Occupational Therapy Assistant
- Herkimer, NY
National Provider Identifier
1083998793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 001787-1
- Practice address
- 255 Gros Blvd
Herkimer, NY 13350-1455 - Phone
- (315) 866-8562
- NPI assigned
- Sep 30, 2011
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 001787-1 | NY | Primary |
Addresses
Primary practice location
255 Gros Blvd
Herkimer, NY 13350-1455
Mailing address
PO Box 381
New Hartford, NY 13413-0381
Phone (315) 732-6911
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001787-1 | NY | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317340800000",
"number": "1083998793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 381",
"city": "NEW HARTFORD",
"state": "NY",
"postal_code": "134130381",
"telephone_number": "315-732-6911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 GROS BLVD",
"city": "HERKIMER",
"state": "NY",
"postal_code": "133501455",
"telephone_number": "315-866-8562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "STACEY",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "ASSOCIATES DEGREE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-30",
"last_updated": "2011-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NY",
"license": "001787-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Herkimer, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.