Individual provider Active NPI

Stephanie Anne Feeley, MS, OTR/L

  • Pediatric Occupational Therapist
  • Fort Collins, CO
National Provider Identifier
1104111350
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
056.009353 Issued in IL
Practice address
3739 Precision Dr Apt 340
Fort Collins, CO 80528-4592
Phone
(815) 353-8837
NPI assigned
Jun 16, 2011
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 056.009353 IL Primary

Addresses

Primary practice location

3739 Precision Dr Apt 340
Fort Collins, CO 80528-4592

Mailing address

3739 Precision Dr Apt 340
Fort Collins, CO 80528-4592
Phone (815) 353-8837

Other practice location 1

3714 Chatham Court
Joliet, IL 60435-1570
Phone (815) 353-8837

Other identifiers 1

IdentifierTypeStateIssuer
63054051MedicaidCO

Other names 1

  • Stephanie Anne Noreiko Former name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
056.009353ILMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1104111350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3739 PRECISION DR APT 340",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805284592",
            "telephone_number": "815-353-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3739 PRECISION DR APT 340",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805284592",
            "telephone_number": "815-353-8837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3714 Chatham Court",
            "address_purpose": "LOCATION",
            "city": "Joliet",
            "state": "IL",
            "postal_code": "604351570",
            "country_code": "US",
            "telephone_number": "815-353-8837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEELEY",
        "first_name": "STEPHANIE",
        "middle_name": "ANNE",
        "credential": "MS, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IL",
            "license": "056.009353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "63054051",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "NOREIKO",
            "middle_name": "ANNE",
            "credential": "MS, OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

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