Stacia T Bryant, PHYSICAL THERAPIST

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

40QA00211000 Issued in NJ

Practice address

14 Bridgewaters Dr Ste a
Oceanport, NJ 07757-1184

Phone

(732) 542-6600

NPI assigned

Jul 16, 2012

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

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.

• Abilities in Action, LLC

  • Clinic/Center
  • Oceanport, NJ
  • NPI 1801146287
  NPD (past)
• Aia Network, LLC

  • Pediatric Occupational Therapist
  • Oceanport, NJ
  • NPI 1316155898

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342396800000",
    "number": "1104171156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 ORLA CT",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077244402",
            "telephone_number": "908-309-8241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 BRIDGEWATERS DR STE A",
            "city": "OCEANPORT",
            "state": "NJ",
            "postal_code": "077571184",
            "telephone_number": "732-542-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "STACIA",
        "middle_name": "T",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-16",
        "last_updated": "2012-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NJ",
            "license": "40QA00211000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marco Bongarzone Jr., DMD
• Lauren Jacobson Borja, MA CCC/SLP
• Caitlin Brinkman, ATC
• Jennifer Lee Brooks
• Elizabeth Ann Brownell, M.D.
• Jacqueline Calderone
• Cheryl Lynn Carbone, M.A., L.P.C.
• Joshua Reuben Cohen, PH.D.
• Community Options Enterprises, Inc.
• Maureen Cox

• Pediatric Physical Therapist in Oceanport, NJ
• Providers in Oceanport, NJ by specialty
• Pediatric Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2012; 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.