Active NPI
Stacy Dawn Lord, CPTA
- Physical Therapy Assistant
- Pittsburg, KS
National Provider Identifier
1700074168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 14-01074
- Practice address
- 140 Huntington Cir
Pittsburg, KS 66762-6864 - Phone
- (620) 308-6025
- NPI assigned
- Oct 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 14-01074 | KS | Primary |
Addresses
Primary practice location
140 Huntington Cir
Pittsburg, KS 66762-6864
Mailing address
140 Huntington Cir
Pittsburg, KS 66762-6864
Phone (620) 308-6025
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
| License | State | Type | Specialty |
|---|---|---|---|
| 14-01074 | KS | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192060800000",
"number": "1700074168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 HUNTINGTON CIR",
"city": "PITTSBURG",
"state": "KS",
"postal_code": "667626864",
"telephone_number": "620-308-6025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 HUNTINGTON CIR",
"city": "PITTSBURG",
"state": "KS",
"postal_code": "667626864",
"telephone_number": "620-308-6025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LORD",
"first_name": "STACY",
"middle_name": "DAWN",
"name_prefix": "Mrs.",
"credential": "CPTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-10-11",
"last_updated": "2007-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "KS",
"license": "14-01074",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pittsburg, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.