Marie Staley

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

4047 13TH St
Saint Cloud, FL 34769

Phone

(407) 957-0370

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Select Physical Therapy Holdings IncGroup PAC ID 9537076401, 1,992 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

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.

• Select Physical Therapy Holdings Inc

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Jacksonville, FL
  • NPI 1669441911
  Medicare reassignment Care Compare group NPD
• Select Physical Therapy Holdings Inc

  • Physical Therapy Clinic/Center
  • Ocoee, FL
  • NPI 1417926700
  NPD

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1205946860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4047 13TH ST",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347696772",
            "telephone_number": "407-957-0370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4047 13TH ST",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "34769",
            "telephone_number": "407-957-0370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "888 White Plains Rd",
            "address_purpose": "LOCATION",
            "city": "Trumbull",
            "state": "CT",
            "postal_code": "066114552",
            "country_code": "US",
            "telephone_number": "203-216-8888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4047 13th St",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "FL",
            "postal_code": "34769",
            "country_code": "US",
            "telephone_number": "407-957-0370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STALEY",
        "first_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "007725",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "PT34506",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• St. Cloud SLC Opco, LLC
• St. Cloud Smiles, Inc.
• St.Cloud Pharmacy & Wellness Center (St Cloud Compounding Pharmacy & Wellness Center)
• St.Cloud Pharmacy&Wellness Center
• St.Cloud Pharmacy&Wellness Center
• Derek S Stallard
• Kimberly Rae Stein, DO
• Stephanie M Cruz, LLC (Sunbeam Mental Care)
• Nikole Stephens
• Shawn Stephens

• Physical Therapist in Saint Cloud, FL
• Providers in Saint Cloud, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; 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.