Active NPI
Stacey Renee Olsen-Patrick, OTR/L
- Occupational Therapist
- Greer, SC
National Provider Identifier
1245491802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1772
- Practice address
- 1305 Boiling Springs Rd
Greer, SC 29650-4139 - Phone
- (864) 458-7566
- NPI assigned
- Jun 17, 2008
- Last updated
- Jun 17, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1772 | SD | Primary |
Addresses
Primary practice location
1305 Boiling Springs Rd
Greer, SC 29650-4139
Mailing address
201 Sturbridge Dr
Greenville, SC 29615-4458
Phone (864) 284-0357
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1772 | SC | MD | Optometrist |
| 1772 | SD | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Magnolia Medical Group Inc | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213660800000",
"number": "1245491802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 STURBRIDGE DR",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296154458",
"telephone_number": "864-284-0357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1305 BOILING SPRINGS RD",
"city": "GREER",
"state": "SC",
"postal_code": "296504139",
"telephone_number": "864-458-7566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSEN-PATRICK",
"first_name": "STACEY",
"middle_name": "RENEE",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-17",
"last_updated": "2008-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "SD",
"license": "1772",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greer, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.