Stacey Ann Mertus

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

AT5417 Issued in CA

Practice address

4655 Ruffner St
Suite #270
San Diego, CA 92111

Phone

(800) 787-6787

Fax

(800) 787-6762

NPI assigned

Aug 15, 2007

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

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.

• Preferred Healthcare

  • Skilled Nursing Facility
  • San Diego, CA
  • NPI 1689995045
  NPD (past)
• Preferred Healthcare Registry

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1386844017
  NPD (past)

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187136000000",
    "number": "1437341302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 RUFFNER ST",
            "address_2": "SUITE #270",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92111",
            "telephone_number": "800-787-6787",
            "fax_number": "800-787-6762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4655 RUFFNER ST",
            "address_2": "SUITE #270",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92111",
            "telephone_number": "800-787-6787",
            "fax_number": "800-787-6762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERTUS",
        "first_name": "STACEY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-15",
        "last_updated": "2007-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "AT5417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stefanie Kelly Merritt, RN
• Victoria Catherine Merritt, PHD
• Alexandra Jacobson Mers
• Aniya Nadirah Mershon, N/A
• Pamela Lee Mertins, RD, CDE
• Ethan Mertz
• Alejandro Daniel Meruelo, M.D., PH.D.
• Vanessa Joy Mervyn-Cohen, DO
• Heather Merz
• Mary Lynn Merz, DDS

• Physical Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Therapist in California

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