Individual provider Active NPI

Stephanie Harris, PTA

  • Physical Therapy Assistant
  • Grand Island, NE
National Provider Identifier
1689938847
Registry record updated Jul 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
730 Issued in NE
Practice address
2300 W Capital Ave
Grand Island, NE 68803-2003
Phone
(308) 385-6252
Fax
(308) 384-2186
NPI assigned
Jul 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 730 NE Primary

Addresses

Primary practice location

2300 W Capital Ave
Grand Island, NE 68803-2003

Mailing address

2300 W Capital Ave
Grand Island, NE 68803-2003
Phone (308) 385-6252

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
730NEMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341187200000",
    "number": "1689938847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 W CAPITAL AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688032003",
            "telephone_number": "308-385-6252",
            "fax_number": "308-384-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 W CAPITAL AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688032003",
            "telephone_number": "308-385-6252",
            "fax_number": "308-384-2186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "STEPHANIE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-02",
        "last_updated": "2012-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NE",
            "license": "730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2012; 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.