Active NPI
Stephanie Michelle O'Malley, DPT
- Pediatric Physical Therapist
- Phoenix, AZ
National Provider Identifier
1649656802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 13498PT
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 13498PT | AZ | MD | Pediatric Physical Therapist |
| PT012014 | GA | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Developmentally Disabled Services Day Training Agency
- Phoenix, AZ
- NPI 1982673992
Physical Therapist
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.