Individual provider Active NPI

Stephen McCroary, PT,DPT

  • Physical Therapist
  • Stoughton, WI
National Provider Identifier
1467059840
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14810-24 Issued in WI
Practice address
814 Jackson St
Stoughton, WI 53589-1520
Phone
(608) 873-6448
NPI assigned
Oct 8, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 14810-24 WI Primary

Addresses

Primary practice location

814 Jackson St
Stoughton, WI 53589-1520

Mailing address

9304 Silverstone LN
Verona, WI 53593-9193
Phone (708) 288-7204

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
14810-24WIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1467059840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9304 SILVERSTONE LN",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535939193",
            "telephone_number": "708-288-7204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 JACKSON ST",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535891520",
            "telephone_number": "608-873-6448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCROARY",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "PT,DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-08",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "14810-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoughton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; 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.