Stacey Lynn Dillard, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

3961 Issued in TN

Practice address

4347 Lebanon Pike
Hermitage, TN 37076-1243

Phone

(615) 871-8283

NPI assigned

Jan 11, 2019

Last updated

Feb 4, 2019By the provider in NPPES

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

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

{
    "created_epoch": "1547164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1093289100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 DENISE DR",
            "city": "OLD HICKORY",
            "state": "TN",
            "postal_code": "371381513",
            "telephone_number": "615-879-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4347 LEBANON PIKE",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370761243",
            "telephone_number": "615-871-8283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLARD",
        "first_name": "STACEY",
        "middle_name": "LYNN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-11",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "3961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elliott T. Deweese, D.M.D., M.S.D.
• DHS Pharmacy LLC. (Hermitage Pharmacy)
• Dialysis Clinic Inc (Dialysis Clinic Inc (Hermitage))
• Daniel Dickson, DPH
• Wudnesh M Digafe
• Amber Elaine Dillehay, LCSW
• Robert Marshall Dimick, MD
• Bradley J Dobner, PT
• Doc Ride Transportation, LLC.
• David Roger Dolbow, PH.D., DPT

• Physical Therapy Assistant in Hermitage, TN
• Providers in Hermitage, TN by specialty
• Physical Therapy Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.