Individual provider Active NPI

Stacey Dawn Svette, COTA/L

  • Occupational Therapy Assistant
  • Knoxville, TN
National Provider Identifier
1508337908
Registry record updated Dec 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
11253371 Issued in TN
Practice address
9910 Coward Mill Rd
Knoxville, TN 37931-3101
Phone
(865) 862-8100
NPI assigned
Dec 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 11253361 TN
Occupational Therapy Assistant 224Z00000X 11253371 TN Primary

Addresses

Primary practice location

9910 Coward Mill Rd
Knoxville, TN 37931-3101

Mailing address

5206 Village Crest Way Apt F256
Knoxville, TN 37924-5043
Phone (423) 620-9006

Other practice location 1

2320 E LaMar Alexander Pkwy
Maryville, TN 37804-5316
Phone (865) 273-8300

Other identifiers 1

IdentifierTypeStateIssuer
11253361OtherTNTENNESSEE STATE LICENSE

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
11253361TNMDOccupational Therapy Assistant
11253371TNMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1544400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1508337908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5206 VILLAGE CREST WAY APT F256",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379245043",
            "telephone_number": "423-620-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9910 COWARD MILL RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379313101",
            "telephone_number": "865-862-8100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2320 E LaMar Alexander Pkwy",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "TN",
            "postal_code": "378045316",
            "country_code": "US",
            "telephone_number": "865-273-8300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SVETTE",
        "first_name": "STACEY",
        "middle_name": "DAWN",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-10",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TN",
            "license": "11253361",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TN",
            "license": "11253371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNESSEE STATE LICENSE",
            "identifier": "11253361",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; 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.