Active NPI
Stephanie Lisa McNulty, P.T.
- Physical Therapist
- Polson, MT
National Provider Identifier
1841540622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTP-PT-LIC-9391
- Practice address
- 103 Whitewater PL Ste D
Polson, MT 59860-4502 - Phone
- (406) 883-8101
- Fax
- (406) 883-8102
- NPI assigned
- Sep 19, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT009286 | GA | |
| Physical Therapist | 225100000X | 5829 | SC | |
| Physical Therapist | 225100000X | PTP-PT-LIC-9391 | MT | Primary |
Addresses
Primary practice location
103 Whitewater PL Ste D
Polson, MT 59860-4502
Mailing address
PO Box 5718
Kalispell, MT 59903-5718
Phone (406) 756-0134
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT009286 | GA | MD | Physical Therapist |
| 5829 | SC | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advance Rehabilitation and Consulting | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Rome, GA
- NPI 1174518682
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626134400000",
"number": "1841540622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5718",
"city": "KALISPELL",
"state": "MT",
"postal_code": "599035718",
"telephone_number": "406-756-0134",
"fax_number": "406-300-1612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 WHITEWATER PL STE D",
"city": "POLSON",
"state": "MT",
"postal_code": "598604502",
"telephone_number": "406-883-8101",
"fax_number": "406-883-8102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCNULTY",
"first_name": "STEPHANIE",
"middle_name": "LISA",
"name_prefix": "Ms.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-19",
"last_updated": "2021-07-13",
"certification_date": "2021-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT009286",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "5829",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MT",
"license": "PTP-PT-LIC-9391",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Polson, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.