NPIMap

Individual provider Active NPI

Stephanie D. Bric, OTR L

  • Occupational Therapist
  • Gig Harbor, WA
National Provider Identifier
1891847679
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT00003485 Issued in WA
Practice address
4411 Point Fosdick Dr NW Ste 101
Gig Harbor, WA 98335-1703
Phone
(253) 851-7472
Fax
(253) 851-7473
NPI assigned
Jan 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT00003485 WA Primary

Addresses

Primary practice location

4411 Point Fosdick Dr NW Ste 101
Gig Harbor, WA 98335-1703

Mailing address

1624 S I St Ste 301
Tacoma, WA 98405-5093
Phone (253) 428-8292

Other identifiers 3

IdentifierTypeStateIssuer
8340275MedicaidWA
186980OtherWALABOR & INDUSTRIES
1624BROtherWAREGENCE

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
3485WAMDOptometrist
OT00003485WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Center for Sports Medicine & Physical Therapy, Inc. Past Accepting new patients
Vashon Physical Therapy PastSince Sep 8, 2015 Accepting new patients
Northwest Center for Sports Medicine & Physical Therapy, Inc. Occupational Therapist PastSince Jul 5, 2001 Accepting new patients

Organizations & group practices 3

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208822400000",
    "number": "1891847679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1624 S I ST STE 301",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055093",
            "telephone_number": "253-428-8292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 POINT FOSDICK DR NW STE 101",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351703",
            "telephone_number": "253-851-7472",
            "fax_number": "253-851-7473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIC",
        "first_name": "STEPHANIE",
        "middle_name": "D.",
        "credential": "OTR L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2008-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT00003485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8340275",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "186980",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "1624BR",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gig Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.