Individual provider Active NPI

Kelly Stiger

  • Physical Therapist
  • Helotes, TX
National Provider Identifier
1861956997
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305214962 Issued in VA
Practice address
12952 Bandera Rd Ste 107
Helotes, TX 78023-4733
Phone
(210) 372-9600
Fax
(210) 392-9923
NPI assigned
Jan 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 18452 NC
Physical Therapist 225100000X 1311009 TX
Physical Therapist 225100000X 2305214962 VA Primary

Addresses

Primary practice location

12952 Bandera Rd Ste 107
Helotes, TX 78023-4733

Mailing address

8627 Cinnamon Creek Dr Ste 402
San Antonio, TX 78240-1482
Phone (210) 372-9600

Other practice location 1

305 E 14th St
Roanoke Rapids, NC 27870-4430
Phone (252) 537-6181

Other practice location 2

12610 Patrick Henry Dr Ste H
Newport News, VA 23602-9538
Phone (757) 874-1470

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

LicenseStateTypeSpecialty
18452NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grays Harbor County Public Hospital District No 1 Current Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Mar 18, 2024 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Mar 18, 2024 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

1490 Pantops Mountain Pl
Ste 202
Charlottesvle, VA 22911
Phone (434) 245-6472

10128 W Broad St
Bldg Iii
Glen Allen, VA 23060
Phone (804) 217-9210

12494 Warwick Blvd
Newport News, VA 23606
Phone (804) 217-9210

600 E Main St
Elma, WA 98541
Phone (360) 346-2222

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1861956997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8627 CINNAMON CREEK DR STE 402",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401482",
            "telephone_number": "210-372-9600",
            "fax_number": "210-392-9923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12952 BANDERA RD STE 107",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780234733",
            "telephone_number": "210-372-9600",
            "fax_number": "210-392-9923"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 E 14th St",
            "address_purpose": "LOCATION",
            "city": "Roanoke Rapids",
            "state": "NC",
            "postal_code": "278704430",
            "country_code": "US",
            "telephone_number": "252-537-6181",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12610 Patrick Henry Dr Ste H",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236029538",
            "country_code": "US",
            "telephone_number": "757-874-1470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STIGER",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-23",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "18452",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1311009",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305214962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Helotes, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.