Stephani L Poe, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160002266 Issued in IL

Practice address

3122 Brettwood Cir
Decatur, IL 62526-2425

Phone

(217) 876-4600

Fax

(217) 876-4625

NPI assigned

Aug 1, 2012

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Decatur Memorial Hospital

  • Multi-Specialty Clinic/Center
  • Decatur, IL
  • NPI 1477276301
  NPD (past)

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

{
    "created_epoch": "1343779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343779200000",
    "number": "1336495985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 E ILLINOIS ST",
            "city": "ARTHUR",
            "state": "IL",
            "postal_code": "619111631",
            "telephone_number": "217-876-4600",
            "fax_number": "217-876-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3122 BRETTWOOD CIR",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625262425",
            "telephone_number": "217-876-4600",
            "fax_number": "217-876-4625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POE",
        "first_name": "STEPHANI",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-01",
        "last_updated": "2012-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146M00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Intermediate",
            "state": "IL",
            "license": "000921426",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160002266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juanette M Plato
• Pleasant Counseling LLC
• Diane S Pleasant, PSYD, LCPC, CADC
• Robyn Ploessl, DPT
• Jasmine Plowman
• Amy Lizette Porter
• Paul Duane Potter, D.D.S.
• Sara Potter, RPH
• Hailey Powell
• Manjeshwar B. Prabhu, M.D.

• Physical Therapy Assistant in Decatur, IL
• Providers in Decatur, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2012; 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.