Active NPI
Stacey Lynne Hannah, LMT
- Rehabilitation Practitioner
- Midland, MI
National Provider Identifier
1700329075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 1914 S Saginaw Rd
Midland, MI 48640-6808 - Phone
- (989) 486-1154
- Fax
- (734) 224-9984
- NPI assigned
- Nov 18, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | L891159 | MI | |
| Rehabilitation Practitioner | 225400000X | Primary |
Addresses
Primary practice location
1914 S Saginaw Rd
Midland, MI 48640-6808
Mailing address
1914 S Saginaw Rd
Midland, MI 48640-6808
Phone (989) 486-1154
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 |
|---|---|---|---|
| L891159 | MI | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496275200000",
"number": "1700329075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1914 S SAGINAW RD",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486406808",
"telephone_number": "989-486-1154",
"fax_number": "734-224-9984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1914 S SAGINAW RD",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486406808",
"telephone_number": "989-486-1154",
"fax_number": "734-224-9984"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANNAH",
"first_name": "STACEY",
"middle_name": "LYNNE",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-11-18",
"last_updated": "2017-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MI",
"license": "L891159",
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.