Individual provider Active NPI

Anni Jean Stafford, MOTR L

  • Occupational Therapist
  • Gillette, WY
National Provider Identifier
1144483330
Registry record updated Nov 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT633L Issued in WY
Practice address
1211 S Douglas Hwy Ste 100
Gillette, WY 82716-4982
Phone
(307) 670-9191
Fax
(307) 670-9193
NPI assigned
Jul 8, 2008
Last updated
Nov 30, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT633L WY Primary

Addresses

Primary practice location

1211 S Douglas Hwy Ste 100
Gillette, WY 82716-4982

Mailing address

1211 S Douglas Hwy Ste 100
Gillette, WY 82716-4982
Phone (307) 670-9191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, SD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170614000937 WY Practitioner - Occupational Therapist in Private Practice 4981972098 Reassigns benefits to 2 organizations
I20260325000794 SD Practitioner - Occupational Therapist in Private Practice 4981972098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hand and Physical Therapy of Wyoming Limited PartnershipGroup PAC ID 5294262119, shared by 10 NPIs, 23 clinicians

Practice addresses (Care Compare)

1301 Avon St
Suite a
Sheridan, WY 82801-2758
Phone (307) 210-9190

344 N Main St
Suite 5
Spearfish, SD 57783-2436
Phone (605) 644-7850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT633LWYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hand Therapy of Wyoming LLC Occupational Therapist CurrentSince May 1, 2017 Accepting new patients
Hand and Physical Therapy of Wyoming Limited Partnership CurrentSince Dec 1, 2024 Accepting new patients
Hand Therapy of Wyoming LLC CurrentSince May 1, 2017 Accepting new patients
Wyolabs Current Accepting new patients
Hand and Physical Therapy of Wyoming Limited Partnership Occupational Therapist CurrentSince Jan 2, 2026 Accepting new patients
Hand and Physical Therapy of Wyoming Limited Partnership Occupational Therapist CurrentSince Dec 1, 2024 Accepting new patients

Locations

38 N Desmet Ave
Ste 2
Buffalo, WY 82834
Phone (307) 278-0256

1211 S Douglas Hwy
Ste 100
Gillette, WY 82716
Phone (307) 228-1005

Organizations & group practices 6

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": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543536000000",
    "number": "1144483330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 S DOUGLAS HWY STE 100",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827164982",
            "telephone_number": "307-670-9191",
            "fax_number": "307-670-9193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 S DOUGLAS HWY STE 100",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827164982",
            "telephone_number": "307-670-9191",
            "fax_number": "307-670-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "ANNI",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "MOTR L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-08",
        "last_updated": "2018-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WY",
            "license": "OT633L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gillette, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; 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.