Individual provider Active NPI

Roxanne Stephenson

  • Physical Therapy Assistant
  • Bradenton, FL
National Provider Identifier
1760875017
Registry record updated Mar 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA23956 Issued in FL
Practice address
710 46TH St E
Bradenton, FL 34208-5864
Phone
(269) 366-0991
NPI assigned
Mar 11, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA23956 FL Primary

Addresses

Primary practice location

710 46TH St E
Bradenton, FL 34208-5864

Mailing address

710 46TH St E
Bradenton, FL 34208-5864
Phone (269) 366-0991

Other names 1

  • Roxanne Stephenson Professional name

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
PTA23956FLMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1426032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426032000000",
    "number": "1760875017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 46TH ST E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342085864",
            "telephone_number": "269-366-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 46TH ST E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342085864",
            "telephone_number": "269-366-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "ROXANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-11",
        "last_updated": "2015-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA23956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROXANNE",
            "last_name": "STEPHENSON",
            "credential": "PTA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; 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.