Individual provider Active NPI

Stacy Sloan-Gutierrez, PT

  • Physical Therapist
  • Weston, FL
National Provider Identifier
1245271972
Registry record updated Feb 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT6211 Issued in FL
Practice address
1440 N Park Dr
Weston, FL 33326-3207
Phone
(954) 385-3595
Fax
(954) 385-3596
NPI assigned
Jun 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2010

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 PT6211 FL Primary

Addresses

Primary practice location

1440 N Park Dr
Weston, FL 33326-3207

Mailing address

1440 N Park Dr
Weston, FL 33326-3207
Phone (954) 385-3595

Other identifiers 1

IdentifierTypeStateIssuer
Y043JOtherFLBCBS OF FLORIDA

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Behnam Myers DO PA CurrentSince Mar 12, 2016 Accepting new patients
Family Health & Wellness Center of Pembroke Pines Inc.Life Chiropracti Physical Therapist Past Accepting new patients
Sunrise Medical Group Inc Physical Therapist Past Accepting new patients
Dynamix Rehab LLC Physical Therapist Past Accepting new patients

Locations

3850 Sheridan St
Hollywood, FL 33021
Phone (954) 983-3888

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13023/brand/4/csg/1/fhir/r4

Organizations & group practices 4

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266537600000",
    "number": "1245271972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 N PARK DR",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333263207",
            "telephone_number": "954-385-3595",
            "fax_number": "954-385-3596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 N PARK DR",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333263207",
            "telephone_number": "954-385-3595",
            "fax_number": "954-385-3596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOAN-GUTIERREZ",
        "first_name": "STACY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2010-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT6211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "Y043J",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2010; 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.