William Stacy, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

8011 Issued in OR

Practice address

590 NW 23Rd St
Redmond, OR 97756-6969

Phone

(541) 460-0356

NPI assigned

Jun 8, 2022

Last updated

Jun 8, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1851020333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "967 NW POPLAR AVE",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561061",
            "telephone_number": "541-460-0356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 NW 23RD ST",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977566969",
            "telephone_number": "541-460-0356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACY",
        "first_name": "WILLIAM",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OR",
            "license": "8011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "private",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "590 NW 23rd St",
            "city": "Redmond",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977566969",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "office",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "office",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "verbal",
            "address_1": "590 NW 23rd St",
            "city": "Redmond",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977566969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• St. Charles Health System, Inc. (St. Charles OB/GYN - Redmond)
• St. Charles Health System, Inc. (The Center at St. Charles Medical Equipment)
• St. Charles Health System, Inc. (St. Charles Pulmonary Clinic - Redmond)
• St. Charles Health System, Inc. (St. Charles Cancer Center - Redmond)
• Scott Stacey, CRM
• Tiffany Stadler, LPC, M.ED
• Kady Stafford, LPC
• Madeline Staiger, DPT
• Kaila Starmer, LPC
• Cherise Steele, LPN

• Physical Therapy Assistant in Redmond, OR
• Providers in Redmond, OR by specialty
• Physical Therapy Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; 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.