Individual provider Active NPI

Amanda Nicole Stacey, MSOTR/L

  • Occupational Therapist
  • Franklin, TN
National Provider Identifier
1215307137
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT3077 Issued in ME
Practice address
870 Oak Meadow Dr
Franklin, TN 37064
Phone
(615) 721-5439
NPI assigned
Oct 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT3077 ME Primary

Addresses

Primary practice location

870 Oak Meadow Dr
Franklin, TN 37064

Mailing address

9101 Wesleyan Rd Ste 100
Indianapolis, IN 46268-3103
Phone (800) 603-6046

Other practice location 1

2263 Route 2
Hermon, ME 04401-0605
Phone (207) 848-9009

Other practice location 2

2263 Route 2
Hermon, ME 04401-0605
Phone (207) 848-9009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.13 of 100Reported as group
Quality
82.29
Improvement activities
40
Cost
59.2

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT3077MEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
TX: Team Rehab Inc. Occupational Therapist CurrentSince May 1, 2019 Accepting new patients

Locations

9101 Wesleyan Rd
Ste 100
Indianapolis, IN 46268
Phone (843) 873-7613

8910 Purdue Rd
Ste 700
Indianapolis, IN 46268

870 Oak Meadow Dr
Franklin, TN 37064
Phone (615) 721-5452

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1215307137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9101 WESLEYAN RD STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462683103",
            "telephone_number": "800-603-6046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 OAK MEADOW DR",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "37064",
            "telephone_number": "615-721-5439"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2263 Route 2",
            "address_purpose": "LOCATION",
            "city": "Hermon",
            "state": "ME",
            "postal_code": "044010605",
            "country_code": "US",
            "telephone_number": "207-848-9009",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2263 Route 2",
            "address_purpose": "LOCATION",
            "city": "Hermon",
            "state": "ME",
            "postal_code": "044010605",
            "country_code": "US",
            "telephone_number": "207-848-9009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STACEY",
        "first_name": "AMANDA",
        "middle_name": "NICOLE",
        "credential": "MSOTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-05",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ME",
            "license": "OT3077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, TN

Sources for this page

  • 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 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.