Individual provider Active NPI

Thomas T Stootsberry

  • Physical Therapist
  • Lincoln, NE
National Provider Identifier
1578650263
Registry record updated Mar 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
398 Issued in NE
Practice address
6319 Havelock Ave
Lincoln, NE 68507-1328
Phone
(402) 325-0044
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2010

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 398 NE Primary

Addresses

Primary practice location

6319 Havelock Ave
Lincoln, NE 68507-1328

Mailing address

6319 Havelock Ave
Lincoln, NE 68507-1328
Phone (402) 325-0044

Other identifiers 2

IdentifierTypeStateIssuer
650017454OtherNERR MEDICARE
36523OtherNEBCBS

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
398NEMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
York Physical Therapy Inc Physical Therapist PastSince Oct 1, 1999 Accepting new patients
Milford Physical Therapy LLC Physical Therapist Past Accepting new patients
Crete Physical Therapy, LLC Physical Therapist Past Accepting new patients
Nebraska City Physical Therapy, LLC Physical Therapist PastSince Feb 15, 2011 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269302400000",
    "number": "1578650263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6319 HAVELOCK AVE",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685071328",
            "telephone_number": "402-325-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6319 HAVELOCK AVE",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685071328",
            "telephone_number": "402-325-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOOTSBERRY",
        "first_name": "THOMAS",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2010-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "650017454",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "36523",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2010; 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.