Individual provider Active NPI

Stephanie Hauck

  • Occupational Therapist
  • Muscatine, IA
National Provider Identifier
1689429151
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
111857 Issued in IA
Practice address
2421 Lutheran Dr
Muscatine, IA 52761-9382
Phone
(563) 263-1241
NPI assigned
Apr 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 111857 IA Primary
Occupational Therapist 225X00000X 056012909 IL

Addresses

Primary practice location

2421 Lutheran Dr
Muscatine, IA 52761-9382

Mailing address

516 Sunrise Cir
Muscatine, IA 52761-2715

Other practice location 1

1000 N Miller St
West Liberty, IA 52776-1102
Phone (319) 627-4775

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240603000430 IA Practitioner - Occupational Therapist in Private Practice 2668914987 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056012909ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Stone Therapy Inc. CurrentSince Jun 16, 2024 Accepting new patients

Locations

811 3rd St
Kalona, IA 52247
Phone (319) 656-2421

2830 100th St
Ste 100
Urbandale, IA 50322
Phone (515) 537-4770

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1713398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1689429151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 SUNRISE CIR",
            "city": "MUSCATINE",
            "state": "IA",
            "postal_code": "527612715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 LUTHERAN DR",
            "city": "MUSCATINE",
            "state": "IA",
            "postal_code": "527619382",
            "telephone_number": "563-263-1241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 N Miller St",
            "address_purpose": "LOCATION",
            "city": "West Liberty",
            "state": "IA",
            "postal_code": "527761102",
            "country_code": "US",
            "telephone_number": "319-627-4775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAUCK",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-18",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": "111857",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056012909",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muscatine, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.