Bradley R Stalder

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

001686 Issued in WV

Practice address

411 N State Route 2
New Martinsville, WV 26155-2711

Phone

(304) 455-5515

NPI assigned

Sep 21, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Wetzel County Homecare, LLC

  dba Wetzel County HomeCare

  • Home Health Agency
  • New Martinsville, WV
  • NPI 1497959944
  NPD

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1093438467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 N STATE ROUTE 2",
            "city": "NEW MARTINSVILLE",
            "state": "WV",
            "postal_code": "261552711",
            "telephone_number": "304-455-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 N STATE ROUTE 2",
            "city": "NEW MARTINSVILLE",
            "state": "WV",
            "postal_code": "261552711",
            "telephone_number": "304-455-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALDER",
        "first_name": "BRADLEY",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WV",
            "license": "001686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "desktop/tablet",
            "affiliation": "N",
            "address_1": "411 N State Route 2",
            "city": "New Martinsville",
            "state": "WV",
            "country_code": "US",
            "postal_code": "261552711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kathy Lynn Smith
• Matthew Paul Smith
• Michael Allen Smith, RN
• Shannon Denise Smith, MA, LPC
• Kayla Sorkin
• Judy Anne Staley
• Helen M Stevens
• Kyra Stewart, PTA
• Julia Stillwagner
• Stonerise Reliable Healthcare LLC (Stonerise Home Health)

• Physical Therapy Assistant in New Martinsville, WV
• Providers in New Martinsville, WV by specialty
• Physical Therapy Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.