Individual provider Active NPI

Stephanie Allen

  • Physical Therapist
  • Ithaca, NY
National Provider Identifier
1093136293
Registry record updated Dec 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
037269 Issued in NY
Practice address
310 Taughannock Blvd
Ithaca, NY 14850-3251
Phone
(607) 252-3500
NPI assigned
Dec 15, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 037269 NY Primary

Addresses

Primary practice location

310 Taughannock Blvd
Ithaca, NY 14850-3251

Mailing address

310 Taughannock Blvd
Ithaca, NY 14850-3251

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
037269NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cayuga Medical Center at Ithaca Past Accepting new patients
Cayuga Medical Center Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1387065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387065600000",
    "number": "1093136293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 TAUGHANNOCK BLVD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148503251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 TAUGHANNOCK BLVD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148503251",
            "telephone_number": "607-252-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-15",
        "last_updated": "2013-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "037269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2013; 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.