Active NPI
Lindsay Wofford Stadler
- Physical Therapist
- Costa Mesa, CA
National Provider Identifier
1144778960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT291724
- Practice address
- 485 E 17TH St
St #650
Costa Mesa, CA 92627-3265 - Phone
- (949) 722-7374
- NPI assigned
- Sep 21, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT291724 | CA | Primary |
Addresses
Primary practice location
485 E 17TH St
St #650
Costa Mesa, CA 92627-3265
Mailing address
209 1/2 Garnet Ave
Newport Beach, CA 92662-2024
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT291724 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493078400000",
"number": "1144778960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 1/2 GARNET AVE",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926622024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "485 E 17TH ST",
"address_2": "ST #650",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926273265",
"telephone_number": "949-722-7374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STADLER",
"first_name": "LINDSAY",
"middle_name": "WOFFORD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-21",
"last_updated": "2017-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT291724",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.