NPIMap

Individual provider Active NPI

Stacy M Trice, MPT, ATC

  • Physical Therapist
  • Wilmington, DE
National Provider Identifier
1871557702
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
J10001870 Issued in DE
Practice address
1812 Marsh Rd
Store 505
Wilmington, DE 19810-4581
Phone
(302) 793-0432
Fax
(302) 793-0400
NPI assigned
Apr 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2007

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X J10001870 DE Primary
Geriatric Physical Therapist 2251G0304X J10001870 DE
Sports Physical Therapist 2251S0007X J10001870 DE
Orthopedic Physical Therapist 2251X0800X J10001870 DE
Athletic Trainer 2255A2300X J3-0000171 DE

Addresses

Primary practice location

1812 Marsh Rd
Store 505
Wilmington, DE 19810-4581

Mailing address

1288 S Governors Ave
Dover, DE 19904-4802
Phone (302) 677-0100

Other identifiers 2

IdentifierTypeStateIssuer
P00284460OtherDERAILROAD MEDICARE
2623564000OtherDEAMERIHEALTH

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
J10001870DEMDSports Physical Therapist
J3-0000171DEMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Physical Therapist Past Accepting new patients

Organizations & group practices 1

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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1871557702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1288 S GOVERNORS AVE",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199044802",
            "telephone_number": "302-677-0100",
            "fax_number": "302-677-0267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 MARSH RD",
            "address_2": "STORE 505",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104581",
            "telephone_number": "302-793-0432",
            "fax_number": "302-793-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRICE",
        "first_name": "STACY",
        "middle_name": "M",
        "credential": "MPT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J10001870",
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "DE",
            "license": "J10001870",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "DE",
            "license": "J10001870",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "DE",
            "license": "J10001870",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "DE",
            "license": "J3-0000171",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00284460",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "2623564000",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.

Verify at the official NPI Registry.