Individual provider Active NPI

Jayme Stachura

  • Physical Therapy Assistant
  • Palm Harbor, FL
National Provider Identifier
1801438593
Registry record updated Oct 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA29268 Issued in FL
Practice address
3825 Countryside Blvd N
Palm Harbor, FL 34684-4928
Phone
(727) 784-2848
NPI assigned
Oct 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2019

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 PTA29268 FL Primary

Addresses

Primary practice location

3825 Countryside Blvd N
Palm Harbor, FL 34684-4928

Mailing address

4287 Tremblay Way
Palm Harbor, FL 34685-2645
Phone (214) 502-5084

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
PTA29268FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571011200000",
    "number": "1801438593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4287 TREMBLAY WAY",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346852645",
            "telephone_number": "214-502-5084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 COUNTRYSIDE BLVD N",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346844928",
            "telephone_number": "727-784-2848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACHURA",
        "first_name": "JAYME",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-14",
        "last_updated": "2019-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA29268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; 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.