Individual provider Active NPI

Stacie Whitfield, MS, OTR/L

  • Occupational Therapist
  • Beulaville, NC
National Provider Identifier
1851932982
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
12880 Issued in NC
Practice address
160 N NC 241 Hwy
Beulaville, NC 28518-8636
Phone
(910) 298-2331
Fax
(910) 375-3031
NPI assigned
Sep 30, 2019
Last updated
Sep 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 12880 NC Primary

Addresses

Primary practice location

160 N NC 241 Hwy
Beulaville, NC 28518-8636

Mailing address

160 N NC 241 Hwy
Beulaville, NC 28518-8636
Phone (910) 298-2331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200128000733 NC Practitioner - Occupational Therapist in Private Practice 3971938663 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
12880NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage OT, PC Occupational Therapist CurrentSince Nov 5, 2019 Accepting new patients
Advantage OT Inc. Occupational Therapist CurrentSince Nov 5, 2019 Accepting new patients

Locations

160 N NC 241 Hwy
Beulaville, NC 28518
Phone (888) 258-6905

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1851932982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 N NC 241 HWY",
            "city": "BEULAVILLE",
            "state": "NC",
            "postal_code": "285188636",
            "telephone_number": "910-298-2331",
            "fax_number": "910-375-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 N NC 241 HWY",
            "city": "BEULAVILLE",
            "state": "NC",
            "postal_code": "285188636",
            "telephone_number": "910-298-2331",
            "fax_number": "910-375-3031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITFIELD",
        "first_name": "STACIE",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-30",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "12880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beulaville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.