Stacy Noll, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8085 Issued in NY

Practice address

159 W 1St St
Oswego, NY 13126-2045

Phone

(315) 342-9575

Fax

(315) 342-7664

NPI assigned

Nov 9, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Stacy Ann Hendricks 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": "1447027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447027200000",
    "number": "1871966036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 SWEET GUM LN",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130901107",
            "telephone_number": "315-622-5397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 W 1ST ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262045",
            "telephone_number": "315-342-9575",
            "fax_number": "315-342-7664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLL",
        "first_name": "STACY",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-09",
        "last_updated": "2015-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "8085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "HENDRICKS",
            "middle_name": "ANN",
            "credential": "PHYSICAL THERAPIST",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melissa Nicolini
• Joseph William Nimeh, MD
• Rayees Nizam, MD
• Amanda Nolan, DO
• Kelly A Nolan, PT, DPT
• Northern Oswego County Health Services, Inc.
• Northern Oswego County Health Services, Inc. Dba Connextcare
• Troy Norton, OT
• Betsy Lynne Noyes, LPN
• Melissa Nugent

• Physical Therapist in Oswego, NY
• Providers in Oswego, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2015; 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.