Stephanie Lynn Anderson, MSOTR
Individual provider Active NPI Occupational Therapist · North Las Vegas, NV
NPI 1891096772 · NPPES record last updated Jan 10, 2022
Key facts
- NPI
- 1891096772
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 10-0068 (NV)
- Practice address
- 1904 Autumn Sage Ave
North Las Vegas, NV 89031-1698 - Phone
- (702) 401-1994
- NPI assigned
- Nov 9, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10-0068 | NV | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 10-0068 | NV | Yes |
Addresses
Primary practice location
1904 Autumn Sage Ave
North Las Vegas, NV 89031-1698
Mailing address
1904 Autumn Sage Ave
North Las Vegas, NV 89031-1698
Phone (702) 401-1994
NPI Registry JSON
{
"created_epoch": "1289260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641772800000",
"number": "1891096772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1904 AUTUMN SAGE AVE",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890311698",
"telephone_number": "702-401-1994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1904 AUTUMN SAGE AVE",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890311698",
"telephone_number": "702-401-1994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "STEPHANIE",
"middle_name": "LYNN",
"credential": "MSOTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-11-09",
"last_updated": "2022-01-10",
"certification_date": "2022-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NV",
"license": "10-0068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Las Vegas, NV
- Emily Rose Anderson
- Jameisha Denise Anderson
- Larry Anderson
- Matthew B. Anderson
- Ross Anderson
- Jennifer Andreas
- Andrew K Mensah MD a PC
- Carol Andrews
- Maurice Andrews
- Terrell Andrews
All providers in North Las Vegas, NV · Occupational Therapist in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.