Active NPI
Aileen Stacy, PT
- Physical Therapist
- Charleston, WV
National Provider Identifier
1851490320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 001563
- Practice address
- 200 Elizabeth St
Charleston, WV 25311-2119 - Phone
- (304) 549-3636
- NPI assigned
- Sep 21, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 001563 | WV | Primary |
Addresses
Primary practice location
200 Elizabeth St
Charleston, WV 25311-2119
Mailing address
1533 Hampton Rd
Charleston, WV 25314-1656
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
| License | State | Type | Specialty |
|---|---|---|---|
| 001563 | WV | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1851490320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1533 HAMPTON RD",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253141656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 ELIZABETH ST",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253112119",
"telephone_number": "304-549-3636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STACY",
"first_name": "AILEEN",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WV",
"license": "001563",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.