Individual provider Active NPI

Stacey Stokes Johnson

  • Occupational Therapist
  • Melbourne, FL
National Provider Identifier
1679212104
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT13316 Issued in FL
Practice address
964 S Harbor City Blvd
Melbourne, FL 32901-1909
Phone
(321) 327-8719
NPI assigned
Jun 2, 2022
Last updated
Jun 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT13316 FL Primary

Addresses

Primary practice location

964 S Harbor City Blvd
Melbourne, FL 32901-1909

Mailing address

245 Cahaba Valley Pkwy Ste 200
Pelham, AL 35124-2217
Phone (205) 942-6820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240830003193 FL Practitioner - Occupational Therapist in Private Practice 5496294621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehab OT FL LLCGroup PAC ID 7810395696, 55 clinicians

Practice addresses (Care Compare)

Sarasota, FL 34238
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab OT FL LLC Occupational Therapist CurrentSince Jul 1, 2024 Accepting new patients

Locations

3882 Central Sarasota Pkwy
Sarasota, FL 34238
Phone (941) 282-7965

7 Carnegie Plz
Cherry Hill, NJ 08003

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, 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": "1654128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1679212104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 CAHABA VALLEY PKWY STE 200",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351242217",
            "telephone_number": "205-942-6820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "964 S HARBOR CITY BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011909",
            "telephone_number": "321-327-8719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "STACEY",
        "middle_name": "STOKES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-02",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT13316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.