Stacey Marie Willoughby

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2306604136 Issued in VA

Practice address

229 Hillcrest Pkwy Ste 250
Chesapeake, VA 23322-2492

Phone

(757) 512-5639

NPI assigned

Dec 16, 2025

Last updated

Dec 22, 2025By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Ivyrehab Sept, LLC

  • Physical Therapist
  • Virginia Beach, VA
  • NPI 1982657433

  Orthopedic

  NPD
• Ivyrehab Sept, LLC

  • Physical Medicine & Rehabilitation Physician
  • Verona, VA
  • NPI 1235955709

  Orthopedic

  NPD (past)

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

{
    "created_epoch": "1765843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1225993843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 COLLEEN CT",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234646566",
            "telephone_number": "757-512-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 HILLCREST PKWY STE 250",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233222492",
            "telephone_number": "757-512-5639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLOUGHBY",
        "first_name": "STACEY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-16",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306604136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Domergue D Willingham, LMT, MMT, C.M.A.
• J. Dewey Willis III, D.D.S
• Renae Willis, LCSW
• Markita Willit
• Haley Ann Willms
• Shaletta Sherrel Wills, DRIVER
• Melissa L Wilson-Baskett, LMHP-R
• Alvita D Wilson
• Frederick L Wilson, EDD
• Jessica Erin Wilson

• Physical Therapy Assistant in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Physical Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2025; 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.