Active NPI
Stacy A Pelletier, OTR/L
- Occupational Therapist
- Mountain Grove, MO
National Provider Identifier
1265695423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2007032812
- Practice address
- 1604 N Main St
Suite C
Mountain Grove, MO 65711-1010 - Phone
- (417) 926-6563
- Fax
- (417) 926-1502
- NPI assigned
- Jul 8, 2008
- Last updated
- Jul 8, 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 | 2007032812 | MO | Primary |
Addresses
Primary practice location
1604 N Main St
Suite C
Mountain Grove, MO 65711-1010
Mailing address
108 N Ingraham St
Norwood, MO 65717-9653
Phone (417) 746-0181
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2007032812 | MO | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | 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.
-
dba Ozarks Healthcare
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215475200000",
"number": "1265695423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 N INGRAHAM ST",
"city": "NORWOOD",
"state": "MO",
"postal_code": "657179653",
"telephone_number": "417-746-0181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1604 N MAIN ST",
"address_2": "SUITE C",
"city": "MOUNTAIN GROVE",
"state": "MO",
"postal_code": "657111010",
"telephone_number": "417-926-6563",
"fax_number": "417-926-1502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELLETIER",
"first_name": "STACY",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-08",
"last_updated": "2008-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MO",
"license": "2007032812",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountain Grove, MO
- Ozark Family Health Care Inc
- Ozarks Medical Center (Ozarks Healthcare Mountain Grove)
- Ozarks Medical Center (Ozarks Healthcare Pharmacy Mountain Grove)
- Ozarks Medical Center (Ozarks Healthcare Wound Care Mountain Grove)
- McKenzie Lynn Peifer
- Katie Dawn Peterson, D.D.S
- Matthew Aaron Pigg, O.D.
- Julie Renae Posey, LCSW
- Rachel Jacleen Powell, LPC
- Regional Services (Coxhealth School Based Telemedicine)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.