Individual provider Active NPI

Annette A Stambaugh

  • Physical Therapist
  • Louisville, KY
National Provider Identifier
1225166010
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT002287 Issued in KY
Practice address
601 S. Floyd St.
Suite 801
Louisville, KY 40202
Phone
(502) 852-7049
Fax
(502) 852-7202
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT002287 KY Primary

Addresses

Primary practice location

601 S. Floyd St.
Suite 801
Louisville, KY 40202

Mailing address

301 N Bonner Ave
Louisville, KY 40207-2248

Other identifiers 1

IdentifierTypeStateIssuer
2287OtherKYLICENSE NUMBER

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
PT002287KYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225166010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N BONNER AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402072248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S. FLOYD ST.",
            "address_2": "SUITE 801",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40202",
            "telephone_number": "502-852-7049",
            "fax_number": "502-852-7202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAMBAUGH",
        "first_name": "ANNETTE",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "PT002287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "2287",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • 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.