Stacy Nicole Alvare, PTA
Individual provider Active NPI Physical Therapy Assistant · Kingsland, GA
NPI 1679719348 · NPPES record last updated Dec 2, 2010
Key facts
- NPI
- 1679719348
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- PTA002436 (GA)
- Practice address
- 100-A Lindsey Lane
Kingsland, GA 31548 - Phone
- (912) 729-1333
- Fax
- (912) 729-5259
- NPI assigned
- Dec 30, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA16364 | FL | MD | Physical Therapy Assistant |
| PTA002436 | GA | MD | Physical Therapy Assistant |
| MA 53221 | FL | MD | Massage Therapist |
| MT 006802 | GA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advance Rehabilitation & Consulting Limited Partnership | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT 006802 | GA | |
| Physical Therapy Assistant | 225200000X | PTA002436 | GA | Yes |
| Physical Therapy Assistant | 225200000X | PTA16364 | FL | |
| Massage Therapist | 225700000X | MA 53221 | FL |
Addresses
Primary practice location
100-A Lindsey Lane
Kingsland, GA 31548
Mailing address
PO Box 949
Rome, GA 30162-0949
Phone (706) 802-1991
Other providers in Kingsland, GA
- Bernard H Agnew
- Amber Alabre
- Lindsay Aldridge
- Bailee Stephens Allen
- Allison Fender, LPC, LLC
- Amato Chiropractic Clinic
- David Matthew Amato
- Lesa A Amato
- Amelia Medical Services, LLC
- Leith D Anania
All providers in Kingsland, GA · Physical Therapy Assistant in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.