Individual provider Active NPI

Stephanie Deanna Neal, OTR/L

  • Occupational Therapist
  • Bangor, ME
National Provider Identifier
1770231995
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT4243 Issued in ME
Practice address
335 Stillwater Ave
Bangor, ME 04401-3993
Phone
(207) 947-1111
NPI assigned
Mar 16, 2022
Last updated
Mar 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT4243 ME Primary

Addresses

Primary practice location

335 Stillwater Ave
Bangor, ME 04401-3993

Mailing address

296 Lang Hill Rd
Palmyra, ME 04965-3607
Phone (207) 416-6196

Other names 1

  • Stephanie Deanna Thomas Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240423002529 ME Practitioner - Occupational Therapist in Private Practice 6002255015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covey Physical TherapyGroup PAC ID 6709045826, 9 clinicians

Practice addresses (Care Compare)

2263 Route 2
Hermon, ME 04401-0605
Phone (207) 848-9009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Covey Physical Therapy CurrentSince Apr 15, 2024 Accepting new patients

Locations

2263 Route 2
Hermon, ME 04401
Phone (207) 848-9009

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1647388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1770231995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 LANG HILL RD",
            "city": "PALMYRA",
            "state": "ME",
            "postal_code": "049653607",
            "telephone_number": "207-416-6196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 STILLWATER AVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013993",
            "telephone_number": "207-947-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL",
        "first_name": "STEPHANIE",
        "middle_name": "DEANNA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-16",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ME",
            "license": "OT4243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "THOMAS",
            "middle_name": "DEANNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.