Active NPI
Elise Nicole Stanislav, OTR/L
- Occupational Therapist
- Annapolis, MD
National Provider Identifier
1720584493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 08372
- Practice address
- 2130 Hideaway CT
Annapolis, MD 21401-2900 - Phone
- (443) 812-8288
- NPI assigned
- Apr 2, 2018
- Last updated
- Feb 23, 2024
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 08372 | MD | Primary |
Addresses
Primary practice location
2130 Hideaway CT
Annapolis, MD 21401-2900
Mailing address
2130 Hideaway CT
Annapolis, MD 21401-2900
Phone (443) 812-8288
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08372 | MD | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthpro Heritage Rehab & Fitness, LLC | Occupational Therapist | Current | Accepting new patients |
| Healthpro Heritage Rehab & Fitness, LLC | Occupational Therapist | Current | Accepting new patients |
Locations
4950 Thunderbird Dr
Boulder, CO 80303
Phone (303) 499-4888
Organizations & group practices 3
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.
-
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- Lafayette, CO
- NPI 1821854126
-
- Physical Therapist
- Boulder, CO
- NPI 1376038646
Occupational Therapist
-
- Physical Therapist
- Independence, MO
- NPI 1871072462
Occupational Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708646400000",
"number": "1720584493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2130 HIDEAWAY CT",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214012900",
"telephone_number": "443-812-8288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2130 HIDEAWAY CT",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214012900",
"telephone_number": "443-812-8288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANISLAV",
"first_name": "ELISE",
"middle_name": "NICOLE",
"name_prefix": "Ms.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-04-02",
"last_updated": "2024-02-23",
"certification_date": "2024-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MD",
"license": "08372",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Annapolis, MD
- Alexa Stamatis, MT-BC, LPMP
- Cornelius Van Der Meer Stamp, M.D.
- Wanda Stan, PA-C
- Christopher James Stange, M.D.
- Kristina R Stanich, PT, DPT, SCS, LAT
- Brooke Stanley, CRNP
- Stephen F Stanziale, M.D.
- Jessica J Staples, D.C.
- Starburst Counseling & Wellness (Helping Hands Counseling & Wellness)
- Charles R. Staubs, DO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.