Stacey L. Martin, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

5502000603 Issued in MI

Practice address

1333 Spring St.
Petoskey, MI 49770

Phone

(231) 487-4638

Fax

(231) 487-4615

NPI assigned

Sep 29, 2010

Last updated

Sep 29, 2010By 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 1

Addresses

Other identifiers 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Timothy I Bondy Inc

  dba Bondy Physical Therapy

  • Orthopedic Physical Therapist
  • Harbor Springs, MI
  • NPI 1437240066
  NPD (past)

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285718400000",
    "number": "1386953099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 487",
            "address_2": "1333 SPRING ST.",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "49770",
            "telephone_number": "231-487-4638",
            "fax_number": "231-487-4615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 SPRING ST.",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "49770",
            "telephone_number": "231-487-4638",
            "fax_number": "231-487-4615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "STACEY",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-29",
        "last_updated": "2010-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502000603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "404773166",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clarissa Martin
• Jennifer Martin
• Joshua D Martin, DNP-NP/C
• Melissa A Martin, MA, LPC, LLMFT
• Michael Martin, MD
• Julie Marie Martinson, DDS
• Martinsondriscoll D.D.S.
• Trevor Matelski
• Matthew L Visconti MD LLC
• Ashley Matusz-Fisher, MD

• Physical Therapy Assistant in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Physical Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.