Individual provider Active NPI

Staci Marie Hayslip, PTA

  • Physical Therapy Assistant
  • Brenham, TX
National Provider Identifier
1851857239
Registry record updated Feb 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2022141 Issued in TX
Practice address
401 E Blue Bell Rd
Brenham, TX 77833-2407
Phone
(979) 836-6611
NPI assigned
Feb 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2019

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 2022141 TX Primary

Addresses

Primary practice location

401 E Blue Bell Rd
Brenham, TX 77833-2407

Mailing address

1974 Hillview Rd
Bellville, TX 77418-4386

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
2022141TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1549843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1851857239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1974 HILLVIEW RD",
            "city": "BELLVILLE",
            "state": "TX",
            "postal_code": "774184386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E BLUE BELL RD",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778332407",
            "telephone_number": "979-836-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYSLIP",
        "first_name": "STACI",
        "middle_name": "MARIE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-11",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2022141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brenham, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; 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.