Stephannie Jo Maca, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

428 Issued in NE

Practice address

5120 Maple St
Omaha, NE 68104-3555

Phone

(402) 366-2561

NPI assigned

Jun 13, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Stephannie Jo Potter Former name

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": "1592006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592006400000",
    "number": "1871118018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7526 N 279TH ST",
            "city": "VALLEY",
            "state": "NE",
            "postal_code": "680648046",
            "telephone_number": "402-366-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5120 MAPLE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681043555",
            "telephone_number": "402-366-2561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACA",
        "first_name": "STEPHANNIE",
        "middle_name": "JO",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-13",
        "last_updated": "2020-06-13",
        "certification_date": "2020-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NE",
            "license": "428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANNIE",
            "last_name": "POTTER",
            "middle_name": "JO",
            "credential": "ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jatysa Marie Maben
• Trena Renee Maben
• Mirguich Mabiala Nzaou
• Jaclyn Mabon
• Kyle Mabus, LMHP, LPC
• Elizabeth Marie Macaitis
• James Macalpine
• Jeffrey Macaraeg, M.D.
• Macarius & Daniel
• Alexandra Rose Macbride, MD

• Athletic Trainer in Omaha, NE
• Providers in Omaha, NE by specialty
• Athletic Trainer in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2020; 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.