Active NPI
Stacy Larson
- Physical Rehabilitation Occupational Therapist
- Cibolo, TX
National Provider Identifier
1508643768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Rehabilitation Occupational Therapist
- License
- 118964
- Practice address
- 816 Everyday Way
Cibolo, TX 78108-4080 - Phone
- (210) 538-3812
- NPI assigned
- Sep 12, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Rehabilitation Occupational Therapist | 225XP0019X | 118964 | TX | Primary |
Addresses
Primary practice location
816 Everyday Way
Cibolo, TX 78108-4080
Mailing address
2821 Berry Way
Schertz, TX 78154-5403
Phone (307) 274-1179
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
| License | State | Type | Specialty |
|---|---|---|---|
| 118964 | TX | MD | Physical Rehabilitation Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694476800000",
"number": "1508643768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2821 BERRY WAY",
"city": "SCHERTZ",
"state": "TX",
"postal_code": "781545403",
"telephone_number": "307-274-1179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "816 EVERYDAY WAY",
"city": "CIBOLO",
"state": "TX",
"postal_code": "781084080",
"telephone_number": "210-538-3812"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "STACY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-09-12",
"last_updated": "2023-09-12",
"certification_date": "2023-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0019X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Physical Rehabilitation",
"state": "TX",
"license": "118964",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cibolo, TX
- Kingdom Alarm Incorporated
- Kayla Constance Krambeck
- Kasey Lynn Krask, OTA
- Anna Krueger
- Baylee Kuhlmann
- Laurie Obrien LPC PLLC
- Jeffrey Augustin Lee Sang, DC
- Legacy Chiropractic LLC (Pure Health and Wellness Chiropractic)
- Andres Leyva, LCSW
- Little Bridge Behavioral Health LLC (Little Bridge Behavioral Health)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.