Individual provider Active NPI

Stacy Jager, MT-BC

  • Music Therapist
  • Lockport, IL
National Provider Identifier
1669215885
Registry record updated Jun 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Music TherapistTaxonomy code 225A00000X
License
15574 Issued in IL
Practice address
1201 Milne Dr
Lockport, IL 60441-3816
Phone
(262) 388-8155
NPI assigned
Jun 15, 2024
Last updated
Jun 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Music Therapist 225A00000X 15574 IL Primary

Addresses

Primary practice location

1201 Milne Dr
Lockport, IL 60441-3816

Mailing address

1201 Milne Dr
Lockport, IL 60441-3816
Phone (262) 388-8155

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
15574ILMDMusic Therapist

NPI Registry JSON

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

{
    "created_epoch": "1718409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718409600000",
    "number": "1669215885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 MILNE DR",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604413816",
            "telephone_number": "262-388-8155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 MILNE DR",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604413816",
            "telephone_number": "262-388-8155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGER",
        "first_name": "STACY",
        "credential": "MT-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-15",
        "last_updated": "2024-06-15",
        "certification_date": "2024-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225A00000X",
            "taxonomy_group": "",
            "desc": "Music Therapist",
            "state": "IL",
            "license": "15574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lockport, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2024; 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.