Individual provider Active NPI

Stephanie Anne Caudle, PT, DPT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1356784045
Registry record updated Apr 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
036199 Issued in NY
Practice address
407 W 13TH St
Suite 3B
New York, NY 10014-1112
Phone
(212) 924-4920
NPI assigned
Apr 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 036199 NY Primary
Physical Therapist 225100000X 6942 SC

Addresses

Primary practice location

407 W 13TH St
Suite 3B
New York, NY 10014-1112

Mailing address

523 Grand St
Apt 2
New York, NY 10002-4103
Phone (336) 366-9127

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6942SCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365638400000",
    "number": "1356784045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 GRAND ST",
            "address_2": "APT 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100024103",
            "telephone_number": "336-366-9127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 W 13TH ST",
            "address_2": "SUITE 3B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100141112",
            "telephone_number": "212-924-4920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAUDLE",
        "first_name": "STEPHANIE",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-11",
        "last_updated": "2013-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "036199",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "6942",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; 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.