Stacey Lee Fleetwood, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11-02852 Issued in KS

Practice address

4911 State Ave
Kansas City, KS 66102-1749

Phone

(913) 287-8851

NPI assigned

Feb 21, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wyandotte Comprehensive Special Education Coop Infant Toddler Division

  • Early Intervention Provider Agency
  • Kansas City, KS
  • NPI 1518220326
  NPD (past)

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300147200000",
    "number": "1538294772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4911 STATE AVE",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661021749",
            "telephone_number": "913-287-8851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4911 STATE AVE",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661021749",
            "telephone_number": "913-287-8851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEETWOOD",
        "first_name": "STACEY",
        "middle_name": "LEE",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2011-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-02852",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2004009998",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2004009998",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "11-02852",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Fitzsimmons
• Maureen Louise Fitzsimmons, RPH
• Danielle Flanagin
• Shannon Lynn Flanigan, LMFT
• Jarrod Allen Flax, MD
• Matthew Morgan Flemer, MD
• Allan Roger Fleming, M.D.
• Kristina Lynn Fletcher, AUD
• Lowell Fletcher
• Gregory Fliess, LPC

• Physical Therapist in Kansas City, KS
• Providers in Kansas City, KS by specialty
• Physical Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2011; 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.