Individual provider Active NPI

Stacey L Billyard, PT, DPT

  • Physical Medicine & Rehabilitation Physician
  • Gilbert, AZ
National Provider Identifier
1114965175
Registry record updated Aug 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
5682 Issued in AZ
Practice address
3485 S Mercy Rd
Suite101
Gilbert, AZ 85297-0429
Phone
(480) 963-2400
Fax
(480) 726-1992
NPI assigned
Jun 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 5682 AZ Primary

Addresses

Primary practice location

3485 S Mercy Rd
Suite101
Gilbert, AZ 85297-0429

Mailing address

3485 S Mercy Rd
Suite101
Gilbert, AZ 85297-0429
Phone (480) 963-2400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050711000137 AZ Practitioner - Physical Therapist in Private Practice 1658307939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Spine and Sport Physical Therapy LLCGroup PAC ID 7214003276, 3 clinicians

Practice addresses (Care Compare)

3485 S Mercy Rd
Suite 101
Gilbert, AZ 85297-0429
Phone (480) 963-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5682AZMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Physical Therapy, LLC Physical Therapist Past Accepting new patients
East Valley Physical Therapy & Aquatic Rehabilitation LTD Physical Therapist PastSince Nov 1, 1999 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282176000000",
    "number": "1114965175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3485 S MERCY RD",
            "address_2": "SUITE101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852970429",
            "telephone_number": "480-963-2400",
            "fax_number": "480-726-1992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3485 S MERCY RD",
            "address_2": "SUITE101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852970429",
            "telephone_number": "480-963-2400",
            "fax_number": "480-726-1992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BILLYARD",
        "first_name": "STACEY",
        "middle_name": "L",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2010-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AZ",
            "license": "5682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.