Kristina R Stanich, PT, DPT, SCS, LAT

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

License

29394 Issued in MD

Practice address

162 Woodside TRL
Annapolis, MD 21401-7229

Phone

(405) 414-8203

NPI assigned

Jun 25, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690070400000",
    "number": "1285049544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 WOODSIDE TRL",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017229",
            "telephone_number": "405-414-8203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 WOODSIDE TRL",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017229",
            "telephone_number": "405-414-8203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANICH",
        "first_name": "KRISTINA",
        "middle_name": "R",
        "credential": "PT, DPT, SCS, LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-25",
        "last_updated": "2023-07-23",
        "certification_date": "2023-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "TX",
            "license": "1209096",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "MD",
            "license": "29394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Marie Stallings, AUD
• Alexa Stamatis, MT-BC, LPMP
• Cornelius Van Der Meer Stamp, M.D.
• Wanda Stan, PA-C
• Christopher James Stange, M.D.
• Elise Nicole Stanislav, OTR/L
• Brooke Stanley, CRNP
• Stephen F Stanziale, M.D.
• Jessica J Staples, D.C.
• Starburst Counseling & Wellness

• Sports Physical Therapist in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Sports Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2023; 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.