Individual provider Active NPI

Stacey Lynn Reese, DPT

  • Physical Therapist
  • Little Egg Harbor TWP, NJ
National Provider Identifier
1114108792
Registry record updated Apr 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01266300 Issued in NJ
Practice address
798 Route 539
Suite 2
Little Egg Harbor TWP, NJ 08087-4203
Phone
(609) 294-4720
Fax
(609) 294-4722
NPI assigned
Nov 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01266300 NJ Primary

Addresses

Primary practice location

798 Route 539
Suite 2
Little Egg Harbor TWP, NJ 08087-4203

Mailing address

798 Route 539
Suite 2
Little Egg Harbor TWP, NJ 08087-4203
Phone (609) 294-4720

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01266300NJMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1195776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240444800000",
    "number": "1114108792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "798 ROUTE 539",
            "address_2": "SUITE 2",
            "city": "LITTLE EGG HARBOR TWP",
            "state": "NJ",
            "postal_code": "080874203",
            "telephone_number": "609-294-4720",
            "fax_number": "609-294-4722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "798 ROUTE 539",
            "address_2": "SUITE 2",
            "city": "LITTLE EGG HARBOR TWP",
            "state": "NJ",
            "postal_code": "080874203",
            "telephone_number": "609-294-4720",
            "fax_number": "609-294-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE",
        "first_name": "STACEY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-23",
        "last_updated": "2009-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01266300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Egg Harbor TWP, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2009; 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.