Active NPI
Stephanie Gillespie, OTR/L
- Occupational Therapist
- Massapequa Park, NY
National Provider Identifier
1629785779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 024499
- Practice address
- 154 Eastlake Ave
Massapequa Park, NY 11762-2399 - Phone
- (516) 308-5200
- NPI assigned
- Oct 28, 2022
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 024499 | NY | Primary |
Addresses
Primary practice location
154 Eastlake Ave
Massapequa Park, NY 11762-2399
Mailing address
662 3Rd PL S
Garden City South, NY 11530-5206
Phone (516) 761-4254
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666915200000",
"number": "1629785779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "662 3RD PL S",
"city": "GARDEN CITY SOUTH",
"state": "NY",
"postal_code": "115305206",
"telephone_number": "516-761-4254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "154 EASTLAKE AVE",
"city": "MASSAPEQUA PARK",
"state": "NY",
"postal_code": "117622399",
"telephone_number": "516-308-5200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLESPIE",
"first_name": "STEPHANIE",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-28",
"last_updated": "2022-10-28",
"certification_date": "2022-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "024499",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Massapequa Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.