Active NPI
Stacy Weaver
- Occupational Therapist
- Glen Mills, PA
National Provider Identifier
1174748834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OC006231L
- Practice address
- 77 Mount Aire Farm Rd
Glen Mills, PA 19342-3356 - Phone
- (302) 898-8145
- NPI assigned
- Apr 16, 2007
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OC006231L | PA | Primary |
Addresses
Primary practice location
77 Mount Aire Farm Rd
Glen Mills, PA 19342-3356
Mailing address
77 Mount Aire Farm Rd
Glen Mills, PA 19342-3356
Phone (302) 898-8145
Other practice location 1
KenCrest Services
502 W Germantown Pike, Suite 200
Plymouth Meeting, PA 19462
Phone (610) 825-9360
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0019355560003 | Other | PA | MA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| OC006231L | PA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561334400000",
"number": "1174748834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77 MOUNT AIRE FARM RD",
"city": "GLEN MILLS",
"state": "PA",
"postal_code": "193423356",
"telephone_number": "302-898-8145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 MOUNT AIRE FARM RD",
"city": "GLEN MILLS",
"state": "PA",
"postal_code": "193423356",
"telephone_number": "302-898-8145"
}
],
"practiceLocations": [
{
"address_1": "KenCrest Services",
"address_2": "502 W Germantown Pike, Suite 200",
"address_purpose": "LOCATION",
"city": "Plymouth Meeting",
"state": "PA",
"postal_code": "19462",
"country_code": "US",
"telephone_number": "610-825-9360",
"fax_number": "610-825-2414",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WEAVER",
"first_name": "STACY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-16",
"last_updated": "2019-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "PA",
"license": "OC006231L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MA",
"identifier": "0019355560003",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glen Mills, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.