Individual provider Active NPI

Stacy Lynne Brown, PT

  • Physical Therapist
  • Tyler, TX
National Provider Identifier
1528962651
Registry record updated Oct 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1060317 Issued in TX
Practice address
1103 Laurelwood Dr
Tyler, TX 75703-3927
Phone
(903) 630-7204
Fax
(903) 630-7205
NPI assigned
Oct 3, 2026
Last updated
Oct 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1060317 TX Primary

Addresses

Primary practice location

1103 Laurelwood Dr
Tyler, TX 75703-3927

Mailing address

1103 Laurelwood Dr
Tyler, TX 75703-3927
Phone (903) 630-7204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790985600000",
    "number": "1528962651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 LAURELWOOD DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033927",
            "telephone_number": "903-630-7204",
            "fax_number": "903-630-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 LAURELWOOD DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033927",
            "telephone_number": "903-630-7204",
            "fax_number": "903-630-7205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "STACY",
        "middle_name": "LYNNE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-03",
        "last_updated": "2026-10-03",
        "certification_date": "2026-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1060317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.