Barbara Jean Stacy, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 9115 Issued in CA

Practice address

31700 Railroad Canyon Rd Ste 1
Canyon Lake, CA 92587-9453

Phone

(951) 246-2670

Fax

(951) 246-2672

NPI assigned

Jan 24, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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.

• Canyon Lake Physical Therapy, Inc

  dba Canyon Lake Physical Therapy

  • Physical Therapist
  • Canyon Lake, CA
  • NPI 1053490557
  Authorized official Same address or phone

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215082581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31700 RAILROAD CANYON RD STE 1",
            "city": "CANYON LAKE",
            "state": "CA",
            "postal_code": "925879453",
            "telephone_number": "951-246-2670",
            "fax_number": "951-246-2672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31700 RAILROAD CANYON RD STE 1",
            "city": "CANYON LAKE",
            "state": "CA",
            "postal_code": "925879453",
            "telephone_number": "951-246-2670",
            "fax_number": "951-246-2672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACY",
        "first_name": "BARBARA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 9115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Rosen
• Sacred Space Marriage Therapy, Prof. Corp
• Susan Lynn Shuman, RN
• Daniele Smith-Morton, DR. (EDD)
• Valerie Lynn Spalding, NP
• Steven D Holmstrom O D Inc (Canyon Lake Optometry)
• Steven D. Holmstrom, O.D.
• Darmisha Strader
• Roger Strong, D.D.S.
• Jeff C. Swink, D.C.

• Physical Therapist in Canyon Lake, CA
• Providers in Canyon Lake, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.