Individual provider Active NPI

Stacey Hodges, LPTA

  • Physical Therapy Assistant
  • Rocky Mount, VA
National Provider Identifier
1831569185
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2306603339 Issued in VA
Practice address
435 Doe Run Rd
Rocky Mount, VA 24151-6168
Phone
(540) 352-0110
NPI assigned
Sep 30, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2015

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 2306603339 VA Primary

Addresses

Primary practice location

435 Doe Run Rd
Rocky Mount, VA 24151-6168

Mailing address

435 Doe Run Rd
Rocky Mount, VA 24151-6168
Phone (540) 352-0110

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
2306603339VAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443571200000",
    "number": "1831569185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 DOE RUN RD",
            "city": "ROCKY MOUNT",
            "state": "VA",
            "postal_code": "241516168",
            "telephone_number": "540-352-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 DOE RUN RD",
            "city": "ROCKY MOUNT",
            "state": "VA",
            "postal_code": "241516168",
            "telephone_number": "540-352-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGES",
        "first_name": "STACEY",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-30",
        "last_updated": "2015-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306603339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.