NPIMap

Individual provider Active NPI

Stacey Lynn Dewolf, DC

  • Physical Medicine & Rehabilitation Physician
  • Scottsdale, AZ
National Provider Identifier
1699887745
Registry record updated Oct 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
4369 Issued in AZ
Practice address
7328 E Deer Valley Rd
Suite 100
Scottsdale, AZ 85255-7454
Phone
(480) 282-8485
Fax
(480) 323-2777
NPI assigned
Aug 31, 2006
Last updated
Oct 14, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7685 AZ
Physical Medicine & Rehabilitation Physician 208100000X 4369 AZ Primary

Addresses

Primary practice location

7328 E Deer Valley Rd
Suite 100
Scottsdale, AZ 85255-7454

Mailing address

PO Box 4457
Cave Creek, AZ 85327-4457
Phone (480) 282-8485

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
7685AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Body Mechanics Physical Therapy Past Accepting new patients
Az Body Mechanics, PLLC Past Accepting new patients

Organizations & group practices 5

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223942400000",
    "number": "1699887745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4457",
            "city": "CAVE CREEK",
            "state": "AZ",
            "postal_code": "853274457",
            "telephone_number": "480-282-8485",
            "fax_number": "480-323-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7328 E DEER VALLEY RD",
            "address_2": "SUITE 100",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852557454",
            "telephone_number": "480-282-8485",
            "fax_number": "480-323-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWOLF",
        "first_name": "STACEY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7685",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AZ",
            "license": "4369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2008; 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.