Active NPI
Staci Lyn Fouke, MS, OTR
- Occupational Therapist
- Weatherford, TX
National Provider Identifier
1881963551
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 114005
- Practice address
- 250 Santa Fe Dr
Weatherford, TX 76086-6585 - Phone
- (817) 550-5058
- NPI assigned
- Dec 23, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 114005 | TX | Primary |
Addresses
Primary practice location
250 Santa Fe Dr
Weatherford, TX 76086-6585
Mailing address
250 Santa Fe Dr
Weatherford, TX 76086-6585
Phone (817) 550-5058
Other practice location 1
2506 Buddy Owens
McAllen, TX 78504
Phone (956) 668-9090
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1764490-07 | Medicaid | TX |
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 114005 | TX | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RGV'S Training Wheels Therapy Clinic, LLC | 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.
-
- Speech-Language Pathologist
- McAllen, TX
- NPI 1669405031
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521504000000",
"number": "1881963551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 SANTA FE DR",
"city": "WEATHERFORD",
"state": "TX",
"postal_code": "760866585",
"telephone_number": "817-550-5058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 SANTA FE DR",
"city": "WEATHERFORD",
"state": "TX",
"postal_code": "760866585",
"telephone_number": "817-550-5058"
}
],
"practiceLocations": [
{
"address_1": "2506 Buddy Owens",
"address_purpose": "LOCATION",
"city": "McAllen",
"state": "TX",
"postal_code": "78504",
"country_code": "US",
"telephone_number": "956-668-9090",
"fax_number": "956-668-9098",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FOUKE",
"first_name": "STACI",
"middle_name": "LYN",
"name_prefix": "Mrs.",
"credential": "MS, OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-23",
"last_updated": "2018-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "114005",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1764490-07",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Weatherford, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.