Stacee Vickers, P.T.

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

004817 Issued in GA

Practice address

318 W Pike St
Suite 104
Lawrenceville, GA 30045-3234

Phone

(678) 377-2833

Fax

(678) 377-2882

NPI assigned

Nov 29, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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.

• All About Kids Therapy Services, Inc.

  • Pediatric Physical Therapist
  • Lawrenceville, GA
  • NPI 1992997563

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1386711067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1092 ADAH LN",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300437225",
            "telephone_number": "678-618-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 W PIKE ST",
            "address_2": "SUITE 104",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300453234",
            "telephone_number": "678-377-2833",
            "fax_number": "678-377-2882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERS",
        "first_name": "STACEE",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "GA",
            "license": "004817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE PROVIDER #",
            "identifier": "307933",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00776993D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP PROVIDER #",
            "identifier": "10037646",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vera Whole Health Wa PC
• Lois Vergis, MS, RD,LD, CDE
• Neha Verma, D.O
• James Robert Vernon, RPH
• Alessandra Vializ-Arroyo, DC
• Catherine Joy Victor
• Neill Videlefsky, MD
• Searle Videlefsky, M.D.
• View Point Health
• View Point Health

• Pediatric Physical Therapist in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Pediatric Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.