Stacey L Corrado, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11-03366 Issued in KS

Practice address

7211 W 110TH St
Overland Park, KS 66210-2339

Phone

(913) 451-7372

Fax

(913) 451-7375

NPI assigned

May 23, 2006

Last updated

Feb 11, 2014By the provider in NPPES

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

Other identifiers 4

Other names 1

• Stacey L Palmer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Serc of Overland Park Kansas LLC

  • Physical Therapist
  • Overland Park, KS
  • NPI 1447208095
  NPD (past) Authorized official
• Mid America Balance Institute of Cass County Missouri

  dba MABI of Cass County

  • Respiratory/Developmental/Rehabilitative Specialist/Technologist
  • Belton, MO
  • NPI 1902050511
  NPD (past)
• Spine & Extremity Rehabilitation Center of Kansas City North Inc

  dba SERC of Kansas City North; SERC of Metro North

  • Physical Therapist
  • Riverside, MO
  • NPI 1962450569
  NPD (past)
• Spine and Extremity Rehabilitation Center of Raytown Inc

  dba SERC of Raytown; SERC of South Raytown; SERC of Belton

  • Physical Therapist
  • Raytown, MO
  • NPI 1568410165
  NPD (past)

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392076800000",
    "number": "1255386165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17134 BEL RAY PL",
            "city": "BELTON",
            "state": "MO",
            "postal_code": "640125331",
            "telephone_number": "816-226-4011",
            "fax_number": "816-524-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7211 W 110TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102339",
            "telephone_number": "913-451-7372",
            "fax_number": "913-451-7375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORRADO",
        "first_name": "STACEY",
        "middle_name": "L",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2014-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-03366",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "110767",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KC",
            "identifier": "31209096",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KS",
            "identifier": "1255386165",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "KA2868003",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "MA4370066",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "PALMER",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Physical Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; 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.