Individual provider Active NPI

Michelle Stucker, OTR

  • Occupational Therapist
  • Austin, TX
National Provider Identifier
1497206999
Registry record updated Oct 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
117973 Issued in TX
Practice address
8505 Cross Park Dr
Ste 120
Austin, TX 78754-4577
Phone
(512) 615-6800
Fax
(512) 615-7121
NPI assigned
Oct 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 117973 TX Primary

Addresses

Primary practice location

8505 Cross Park Dr
Ste 120
Austin, TX 78754-4577

Mailing address

8505 Cross Park Dr
Ste 120
Austin, TX 78754-4577
Phone (512) 615-6800

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
117973TXMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1497206999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8505 CROSS PARK DR",
            "address_2": "STE 120",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787544577",
            "telephone_number": "512-615-6800",
            "fax_number": "512-615-7121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8505 CROSS PARK DR",
            "address_2": "STE 120",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787544577",
            "telephone_number": "512-615-6800",
            "fax_number": "512-615-7121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCKER",
        "first_name": "MICHELLE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-19",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "117973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; 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.