Individual provider Active NPI

Michael Jeffrey Stocker

  • Physical Therapy Assistant
  • Puyallup, WA
National Provider Identifier
1245022698
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA013208 Issued in OH
Practice address
15614 Meridian E Ste 100
Puyallup, WA 98375-5100
Phone
(253) 840-5511
NPI assigned
May 21, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA013208 OH Primary

Addresses

Primary practice location

15614 Meridian E Ste 100
Puyallup, WA 98375-5100

Mailing address

10115 Little Mountain Rd
Mentor, OH 44060-8200
Phone (440) 667-8387

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
PTA013208OHMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1747785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1245022698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10115 LITTLE MOUNTAIN RD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440608200",
            "telephone_number": "440-667-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15614 MERIDIAN E STE 100",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983755100",
            "telephone_number": "253-840-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKER",
        "first_name": "MICHAEL",
        "middle_name": "JEFFREY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-21",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "PTA013208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.