Individual provider Active NPI

Allison Stallard, OTR-L

  • Pediatric Occupational Therapist
  • Wyoming, PA
National Provider Identifier
1457070773
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OC018601 Issued in PA
Practice address
311 Wyoming Ave
Wyoming, PA 18644-1620
Phone
(570) 336-0309
NPI assigned
Aug 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OC018601 PA
Pediatric Occupational Therapist 225XP0200X OC018601 PA Primary

Addresses

Primary practice location

311 Wyoming Ave
Wyoming, PA 18644-1620

Mailing address

PO Box 241
Dallas, PA 18612-0241
Phone (570) 336-0309

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220919002703 PA Practitioner - Occupational Therapist in Private Practice 7911382445 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OC018601PAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Well-Nurtured Development Occupational Therapist CurrentSince Aug 16, 2022 Accepting new patients

Locations

301 Lake St
Dallas, PA 18612
Phone (570) 674-6954

960 Wyoming Ave
Forty Fort, PA 18704
Phone (570) 287-8887

311 Wyoming Ave
Wyoming, PA 18644
Phone (570) 336-0309

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1457070773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 241",
            "city": "DALLAS",
            "state": "PA",
            "postal_code": "186120241",
            "telephone_number": "570-336-0309",
            "fax_number": "272-207-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 WYOMING AVE",
            "city": "WYOMING",
            "state": "PA",
            "postal_code": "186441620",
            "telephone_number": "570-336-0309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLARD",
        "first_name": "ALLISON",
        "credential": "OTR-L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC018601",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "PA",
            "license": "OC018601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.