Active NPI
Lesley R Stucker, PT
- Physical Therapist
- Guthrie Center, IA
National Provider Identifier
1679154991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 02550
- Practice address
- 2400 Poplar Ave
Guthrie Center, IA 50115-8878 - Phone
- (641) 747-3225
- NPI assigned
- Apr 19, 2021
- Last updated
- Apr 19, 2021
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 02550 | IA | Primary |
Addresses
Primary practice location
2400 Poplar Ave
Guthrie Center, IA 50115-8878
Mailing address
18317 160TH St
Perry, IA 50220-6314
Phone (515) 360-0082
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA | Other | WELLMARK BLUE CROSS BLUE SHIELD |
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 |
|---|---|---|---|
| 02550 | IA | MD | Physical Therapist |
Practice roles
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618790400000",
"number": "1679154991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18317 160TH ST",
"city": "PERRY",
"state": "IA",
"postal_code": "502206314",
"telephone_number": "515-360-0082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 POPLAR AVE",
"city": "GUTHRIE CENTER",
"state": "IA",
"postal_code": "501158878",
"telephone_number": "641-747-3225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STUCKER",
"first_name": "LESLEY",
"middle_name": "R",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-19",
"last_updated": "2021-04-19",
"certification_date": "2021-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "02550",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BLUE CROSS BLUE SHIELD",
"identifier": "NA",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Guthrie Center, IA
- James Matthew Shultz, D.C.
- Cody Marie Silker-Wilhite, D.O.
- Springbrook Family Dentistry, PC
- Allison H Stanley, OTR/L
- Roma Marie Stetzel, MSW
- Synergy Wellness & Physical Therapy LLC
- The Capstone Group Inc (The New Homestead)
- The Capstone Group, Inc
- TNH Operations, LLC (The New Homestead Care Center)
- Sara Ann Vaneffen, ARNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.