Individual provider Active NPI

Stacey L Hart, P.T.A.

  • Specialist
  • Maple Valley, WA
National Provider Identifier
1548511777
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
P1 60042716 Issued in WA
Practice address
24216 Witte Rd SE
Maple Valley, WA 98038-6827
Phone
(425) 433-3500
NPI assigned
Sep 27, 2012
Last updated
Sep 27, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X P1 60042716 WA Primary

Addresses

Primary practice location

24216 Witte Rd SE
Maple Valley, WA 98038-6827

Mailing address

24216 Witte Rd SE
Maple Valley, WA 98038-6827
Phone (425) 433-3500

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
P1 60042716WAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1348704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1548511777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24216 WITTE RD SE",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980386827",
            "telephone_number": "425-433-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24216 WITTE RD SE",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980386827",
            "telephone_number": "425-433-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "STACEY",
        "middle_name": "L",
        "credential": "P.T.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-27",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "P1 60042716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; 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.