Breanne Alanna Stuckey, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT04587 Issued in IA

Practice address

450 Laurel St
Des Moines, IA 50314-3045

Phone

(515) 323-6485

Fax

(515) 323-6486

NPI assigned

Sep 15, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Breanne Alanna Staples Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1284508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292371200000",
    "number": "1306154190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 LAUREL ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503143045",
            "telephone_number": "515-323-6485",
            "fax_number": "515-323-6486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 LAUREL ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503143045",
            "telephone_number": "515-323-6485",
            "fax_number": "515-323-6486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCKEY",
        "first_name": "BREANNE",
        "middle_name": "ALANNA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-15",
        "last_updated": "2010-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "PT04587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BREANNE",
            "last_name": "STAPLES",
            "middle_name": "ALANNA",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Des Moines, IA
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; 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.