Kaleigh Renee Stafford

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

32003182A Issued in IN

Practice address

2012 Ironwood Cir
South Bend, IN 46635-1888

Phone

(574) 387-4049

NPI assigned

Jan 6, 2021

Last updated

Jan 6, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1659969525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 TAYLORS WAY",
            "city": "NORTH LIBERTY",
            "state": "IN",
            "postal_code": "465549224",
            "telephone_number": "574-360-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 IRONWOOD CIR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351888",
            "telephone_number": "574-387-4049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "KALEIGH",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-06",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IN",
            "license": "32003182A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan M St. Ville, PH.D., MSW, LCSW
• Christine F Stacey, LCSW
• Diane M Stacker, O.T.
• Samantha Morgan Stacy
• Jack Staddon, M.D., PH.D.
• Cheryl Ann Stahl, FNP-BC
• Madelyn Stahl, RPH
• Alec Thomas Staiger, DO
• Alyssa Stair, RBT
• Peri R Stangas, PA-C

• Occupational Therapy Assistant in South Bend, IN
• Providers in South Bend, IN by specialty
• Occupational Therapy Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; 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.