Michael Duane Stephens, ATC, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA20905 Issued in FL

Practice address

120 Beckrich Rd
Suite 130
Panama City Beach, FL 32407-2521

Phone

(850) 235-6360

Fax

(850) 235-7781

NPI assigned

Aug 12, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218585600000",
    "number": "1235385030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 TREASURE PALM DR",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324087715",
            "telephone_number": "850-235-6360",
            "fax_number": "850-235-8871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 BECKRICH RD",
            "address_2": "SUITE 130",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324072521",
            "telephone_number": "850-235-6360",
            "fax_number": "850-235-7781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "MICHAEL",
        "middle_name": "DUANE",
        "credential": "ATC, PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2008-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL1308",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA20905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaleiyah Caprice Spaulding, PSY.D.
• Cynda St Cere, ARNP
• Ashley Brooke Stanley, RBT
• Taylor Stanley
• Stephen C Myers, DMD, PA
• Gregory James Stepp, M.D.
• Sanna-Shae Sterling
• Joshua Stewart, DPT
• Tia Lachelle Stolz
• Clark Reed Stream, PA-C

• Physical Therapy Assistant in Panama City Beach, FL
• Providers in Panama City Beach, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; 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.