Individual provider Active NPI

Stacy Brisco

  • Occupational Therapist
  • Carmel, IN
National Provider Identifier
1821534538
Registry record updated Jan 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
310017421A Issued in IN
Practice address
13431 Old Meridian St
Suite 225
Carmel, IN 46032-7101
Phone
(317) 249-2616
Fax
(317) 249-2618
NPI assigned
Jan 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2017

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 310017421A IN Primary

Addresses

Primary practice location

13431 Old Meridian St
Suite 225
Carmel, IN 46032-7101

Mailing address

13431 Old Meridian St
Suite 225
Carmel, IN 46032-7101
Phone (317) 249-2616

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
310017421AINMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484784000000",
    "number": "1821534538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13431 OLD MERIDIAN ST",
            "address_2": "SUITE 225",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460327101",
            "telephone_number": "317-249-2616",
            "fax_number": "317-249-2618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13431 OLD MERIDIAN ST",
            "address_2": "SUITE 225",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460327101",
            "telephone_number": "317-249-2616",
            "fax_number": "317-249-2618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISCO",
        "first_name": "STACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-19",
        "last_updated": "2017-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "310017421A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; 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.