Individual provider Active NPI

Stacy Labar, OTR/L

  • Pediatric Occupational Therapist
  • Northglenn, CO
National Provider Identifier
1467622811
Registry record updated Dec 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
1035295 Issued in CO
Practice address
11154 Huron Street
#101
Northglenn, CO 80234-2329
Phone
(303) 886-5348
Fax
(303) 562-2415
NPI assigned
Mar 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 1035295 CO Primary

Addresses

Primary practice location

11154 Huron Street
#101
Northglenn, CO 80234-2329

Mailing address

11154 Huron Street
#101
Northglenn, CO 80234-2329
Phone (303) 886-5348

Other identifiers 1

IdentifierTypeStateIssuer
52605272MedicaidCO

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
1035295COMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1204329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419984000000",
    "number": "1467622811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11154 HURON STREET",
            "address_2": "#101",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802342329",
            "telephone_number": "303-886-5348",
            "fax_number": "303-562-2415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11154 HURON STREET",
            "address_2": "#101",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802342329",
            "telephone_number": "303-886-5348",
            "fax_number": "303-562-2415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABAR",
        "first_name": "STACY",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-01",
        "last_updated": "2014-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CO",
            "license": "1035295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52605272",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northglenn, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; 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.