Stacie R Wortman, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN118427IV Issued in OH

Practice address

2771 Boving Rd SW
Lancaster, OH 43130-8939

Phone

(740) 654-7212

NPI assigned

Sep 27, 2007

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190851200000",
    "number": "1508053166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2771 BOVING RD SW",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431308939",
            "telephone_number": "740-654-7212",
            "fax_number": "740-654-7212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2771 BOVING RD SW",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431308939",
            "telephone_number": "740-654-7212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTMAN",
        "first_name": "STACIE",
        "middle_name": "R",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-27",
        "last_updated": "2007-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN118427IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhonda Gayl Woods
• Ermias Getachew Workneh, DDS
• Worth Saying Speech Therapy LLC
• Jack Thomas Worth, OTR/L
• Megan Malette Worthington, MA CCC-SLP
• Wright Care Home Medical Supplies Inc
• James Allen Wright, PA-C
• Michelle E Wright, M.A., CCC/SLP
• Chunghway David Wu, PT, DPT
• Judith Wymer

• All providers in Lancaster, OH
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.