Individual provider Active NPI

Danielle Staley, DPT

  • Pediatric Physical Therapist
  • Clarksville, TN
National Provider Identifier
1104306216
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
16421 Issued in TN
Practice address
851 Professional Park Dr
Clarksville, TN 37040-5257
Phone
(931) 542-2168
NPI assigned
Aug 17, 2018
Last updated
May 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 1306741 TX
Pediatric Physical Therapist 2251P0200X 16421 TN Primary

Addresses

Primary practice location

851 Professional Park Dr
Clarksville, TN 37040-5257

Mailing address

1314 Windermere Way
Princeton, TX 75407-6812
Phone (480) 521-3883

Other practice location 1

60 Noble Ct Ste 120
Heath, TX 75032-6355
Phone (325) 793-3400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250721003580 TN Practitioner - Physical Therapist in Private Practice 1052827656

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16421TNMDPediatric Physical Therapist
1306741TXMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Therapy Solutions Pediatrics CurrentSince May 8, 2025 Accepting new patients

Locations

397 Tiny Town Rd
Clarksville, TN 37042

397 Tiny Town Rd
#B
Clarksville, TN 37042
Phone (931) 999-7400

851 Professional Park Dr
Clarksville, TN 37040
Phone (931) 542-2168

248 Centre St
Ste 200
Pleasant View, TN 37146
Phone (615) 619-2390

Organizations & group practices 1

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": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1104306216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 WINDERMERE WAY",
            "city": "PRINCETON",
            "state": "TX",
            "postal_code": "754076812",
            "telephone_number": "480-521-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 PROFESSIONAL PARK DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405257",
            "telephone_number": "931-542-2168"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60 Noble Ct Ste 120",
            "address_purpose": "LOCATION",
            "city": "Heath",
            "state": "TX",
            "postal_code": "750326355",
            "country_code": "US",
            "telephone_number": "325-793-3400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STALEY",
        "first_name": "DANIELLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-17",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "TX",
            "license": "1306741",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "TN",
            "license": "16421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.