NPIMap

Individual provider Active NPI

Stacy M McDaniel, DPT, MOT

  • Physical Therapist
  • Port Orange, FL
National Provider Identifier
1831288232
Registry record updated Sep 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT22739 Issued in FL
Practice address
5833 Riverside Dr
Port Orange, FL 32127-6431
Phone
(386) 566-1502
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT22739 FL Primary
Occupational Therapist 225X00000X OT10304 FL

Addresses

Primary practice location

5833 Riverside Dr
Port Orange, FL 32127-6431

Mailing address

5833 Riverside Dr
Port Orange, FL 32127-6431
Phone (386) 566-1502

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Motion for Life LLC Current Accepting new patients
Performance Physical Therapy, LLC Physical Therapist Past Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442275200000",
    "number": "1831288232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5833 RIVERSIDE DR",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321276431",
            "telephone_number": "386-566-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5833 RIVERSIDE DR",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321276431",
            "telephone_number": "386-566-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "STACY",
        "middle_name": "M",
        "credential": "DPT, MOT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2015-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT22739",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT10304",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.