Individual provider Active NPI

Stacey Lynette Lantz

  • Physical Therapy Assistant
  • Meadville, PA
National Provider Identifier
1811533508
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
TEI002586 Issued in PA
Practice address
11277 Vernon Place Road
Meadville, PA 16335
Phone
(814) 333-5214
Fax
(814) 333-1482
NPI assigned
Nov 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 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 TEI002586 PA Primary

Addresses

Primary practice location

11277 Vernon Place Road
Meadville, PA 16335

Mailing address

11277 Vernon Place Road
Meadville, PA 16335
Phone (814) 333-5214

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
TEI002586PAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1811533508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11277 VERNON PLACE ROAD",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "16335",
            "telephone_number": "814-333-5214",
            "fax_number": "814-333-1482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11277 VERNON PLACE ROAD",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "16335",
            "telephone_number": "814-333-5214",
            "fax_number": "814-333-1482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANTZ",
        "first_name": "STACEY",
        "middle_name": "LYNETTE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TEI002586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meadville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.