Individual provider Active NPI

Linda Stefanick, OTR

  • Gerontology Occupational Therapist
  • Pompano Beach, FL
National Provider Identifier
1174741763
Registry record updated Aug 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Occupational TherapistTaxonomy code 225XG0600X
License
OT 12853 Issued in FL
Practice address
830 Lakeside Cir
Pompano Beach, FL 33060-7748
Phone
(954) 783-4005
NPI assigned
Apr 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Occupational Therapist 225XG0600X OT 12853 FL Primary

Addresses

Primary practice location

830 Lakeside Cir
Pompano Beach, FL 33060-7748

Mailing address

1240 SE 6TH Ter
Pompano Beach, FL 33060-9411
Phone (508) 341-2378

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OT 12853FLMDGerontology Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1177200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344556800000",
    "number": "1174741763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 SE 6TH TER",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330609411",
            "telephone_number": "508-341-2378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 LAKESIDE CIR",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330607748",
            "telephone_number": "954-783-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFANICK",
        "first_name": "LINDA",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-22",
        "last_updated": "2012-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "FL",
            "license": "OT 12853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2012; 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.