Individual provider Active NPI

Stacia C Hastings, OTRL BCP

  • Occupational Therapist
  • Alpharetta, GA
National Provider Identifier
1093864332
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT004359 Issued in GA
Practice address
11940 Alpharetta Hwy
Suite 150
Alpharetta, GA 30009
Phone
(770) 754-0085
Fax
(770) 754-9288
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT004359 GA Primary

Addresses

Primary practice location

11940 Alpharetta Hwy
Suite 150
Alpharetta, GA 30009

Mailing address

11940 Alpharetta Hwy
Suite 150
Alpharetta, GA 30009-2007
Phone (770) 754-0085

Other identifiers 1

IdentifierTypeStateIssuer
706253431AMedicaidGA

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

LicenseStateTypeSpecialty
OT004359GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Shelland Occupational Therapist Past Accepting new patients
Wexcom Inc Dba Sharon B Wexler 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222128000000",
    "number": "1093864332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11940 ALPHARETTA HWY",
            "address_2": "SUITE 150",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300092007",
            "telephone_number": "770-754-0085",
            "fax_number": "770-754-9288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11940 ALPHARETTA HWY",
            "address_2": "SUITE 150",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "30009",
            "telephone_number": "770-754-0085",
            "fax_number": "770-754-9288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASTINGS",
        "first_name": "STACIA",
        "middle_name": "C",
        "credential": "OTRL BCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2008-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT004359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "706253431A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; 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.