Individual provider Active NPI

Stacy Lynn Hulsey-Brown, PT

  • Physical Therapy Clinic/Center
  • Arlington, TX
National Provider Identifier
1245822824
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
1116895 Issued in TX
Practice address
4025 Woodland Park Blvd Ste 120
Arlington, TX 76013-4301
Phone
(817) 792-2030
Fax
(817) 792-2031
NPI assigned
Feb 5, 2021
Last updated
Jun 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 1116895 TX Primary

Addresses

Primary practice location

4025 Woodland Park Blvd Ste 120
Arlington, TX 76013-4301

Mailing address

4025 Woodland Park Blvd Ste 120
Arlington, TX 76013-4301
Phone (817) 792-2030

Other identifiers 1

IdentifierTypeStateIssuer
1116895OtherTXPT LICENSE

Other names 1

  • Mrs. Stacy Lynn Brown Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210303002705 TX Practitioner - Physical Therapist in Private Practice 9638209422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arlington Physical Therapy PCGroup PAC ID 2668428681, 5 clinicians

Practice addresses (Care Compare)

2310 W I
20 Suite 204
Arlington, TX 76017-1678
Phone 81746672765

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Classic Hospice LLC CurrentSince Aug 4, 2016 Accepting new patients
SLH Health Corp CurrentSince Mar 29, 2009 Accepting new patients

Locations

4025 Woodland Park Blvd
Ste 120
Arlington, TX 76013
Phone (817) 792-2030

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Classic Home CareArlington, TX, CCN 747434 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer (100%)
Corporate Director (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Dec 4, 2009
Mar 29, 2009
Dec 4, 2009
Dec 4, 2009
Mar 29, 2009

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, 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": "1612483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1245822824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 WOODLAND PARK BLVD STE 120",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760134301",
            "telephone_number": "817-792-2030",
            "fax_number": "817-792-2031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 WOODLAND PARK BLVD STE 120",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760134301",
            "telephone_number": "817-792-2030",
            "fax_number": "817-792-2031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULSEY-BROWN",
        "first_name": "STACY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-05",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "TX",
            "license": "1116895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "1116895",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "BROWN",
            "middle_name": "LYNN",
            "prefix": "MRS.",
            "credential": "PT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Arlington, TX

Sources for this page

Verify at the official NPI Registry.