Active NPI
Stacey A Mink, COTA/L
- Occupational Therapy Assistant
- Louisville, KY
National Provider Identifier
1740612431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 5202007690
- Practice address
- 303 N. Hurstbourne Parkway
Suite 200
Louisville, KY 40222 - Phone
- (502) 412-5847
- NPI assigned
- Aug 5, 2013
- Sex
- Female
- Sole proprietor
- No
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 Therapy Assistant | 224Z00000X | 5202007690 | MI | Primary |
Addresses
Primary practice location
303 N. Hurstbourne Parkway
Suite 200
Louisville, KY 40222
Mailing address
335 Brandt Rd.
Ortonville, MI 48462
Phone (810) 919-2653
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 |
|---|---|---|---|
| 5202007690 | MI | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375660800000",
"number": "1740612431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "335 BRANDT RD.",
"city": "ORTONVILLE",
"state": "MI",
"postal_code": "48462",
"telephone_number": "810-919-2653"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 N. HURSTBOURNE PARKWAY",
"address_2": "SUITE 200",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "40222",
"telephone_number": "502-412-5847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINK",
"first_name": "STACEY",
"middle_name": "A",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-05",
"last_updated": "2013-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MI",
"license": "5202007690",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.