Staci A Hildebrandt, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

005465 Issued in KY

Practice address

702 Barrett Blvd
Ste B
Henderson, KY 42420-4931

Phone

(270) 631-4100

Fax

(270) 631-4101

NPI assigned

Dec 6, 2005

Last updated

Feb 14, 2012By 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

• Staci A Burns Former name

Medicare fee-for-service enrollment

Enrolled in IN, KY2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prorehab IncGroup PAC ID 1254317217, 81 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: referral1@prorehab-henderson.direct.kno2fy.com

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.

• Prorehab Inc

  • Physical Therapist
  • Evansville, IN
  • NPI 1770565509

  KY

  Medicare reassignment Care Compare group NPD
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Indianapolis, IN
  • NPI 1336252451

  Physical Therapist

  Medicare reassignment NPD
• Tri-State Orthopaedic Surgeons, Inc.

  • Orthopaedic Surgery Physician
  • Evansville, IN
  • NPI 1073501003
  Medicare reassignment NPD
• Prorehab Inc

  dba ProRehab of Bowling Green

  • Physical Therapy Clinic/Center
  • Bowling Green, KY
  • NPI 1760976146
  NPD
• Orthopaedics-Indianapolis, Inc

  dba Orthoindy

  • Orthopaedic Surgery Physician
  • Terre Haute, IN
  • NPI 1285433953
  NPD
• Orthopaedics-Indianapolis, Inc.

  • Orthopaedic Surgery Physician
  • Greenwood, IN
  • NPI 1932419215
  NPD
• Prorehab Inc

  • Durable Medical Equipment & Medical Supplies
  • Vincennes, IN
  • NPI 1841014933

  Physical Therapist

  NPD
• Tri-State Orthopaedic Surgeons, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Vincennes, IN
  • NPI 1699414961
  NPD
• Prorehab Inc

  • Durable Medical Equipment & Medical Supplies
  • Rockport, IN
  • NPI 1053585992

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329177600000",
    "number": "1295719847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 E INDIANA ST",
            "address_2": "STE 102",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477152794",
            "telephone_number": "812-476-0409",
            "fax_number": "812-476-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 BARRETT BLVD",
            "address_2": "STE B",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424204931",
            "telephone_number": "270-631-4100",
            "fax_number": "270-631-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILDEBRANDT",
        "first_name": "STACI",
        "middle_name": "A",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2012-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05008671A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "005465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200818510",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000378690",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000558412",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000721633",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACI",
            "last_name": "BURNS",
            "middle_name": "A",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Henderson Pediatrics, PSC
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• Kara Dawn Henshaw, FNP-C
• Heather Hensley, OTR
• Amy M Herr, P.T.
• Mariah Hildreth
• Elizabeth Jane Hill, LCSW
• Karen E Hill
• John David Hinton, R.PH.
• Shelby Nichole Hite

• Physical Therapist in Henderson, KY
• Providers in Henderson, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.