Individual provider Active NPI

Stephanie Michelle O'Malley, DPT

  • Pediatric Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1649656802
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
13498PT Issued in AZ
Practice address
1007 N 7TH St
Phoenix, AZ 85006-2728
Phone
(602) 943-5472
NPI assigned
Aug 10, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X PT012014 GA
Pediatric Physical Therapist 2251P0200X 13498PT AZ Primary

Addresses

Primary practice location

1007 N 7TH St
Phoenix, AZ 85006-2728

Mailing address

3309 N 25TH PL
Phoenix, AZ 85016-7427
Phone (928) 581-0667

Other practice location 1

2170 Benton Blvd
#6307
Pooler, GA 31407
Phone (928) 581-0667

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
13498PTAZMDPediatric Physical Therapist
PT012014GAMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
United Cerebral Palsy Association of Central Arizona Physical Therapist Past Accepting new patients

Organizations & group practices 1

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": "1439164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1649656802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3309 N 25TH PL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167427",
            "telephone_number": "928-581-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 N 7TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062728",
            "telephone_number": "602-943-5472"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2170 Benton Blvd",
            "address_2": "#6307",
            "address_purpose": "LOCATION",
            "city": "Pooler",
            "state": "GA",
            "postal_code": "31407",
            "country_code": "US",
            "telephone_number": "928-581-0667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'MALLEY",
        "first_name": "STEPHANIE",
        "middle_name": "MICHELLE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "GA",
            "license": "PT012014",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "AZ",
            "license": "13498PT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.