Stacy Lynn Panetta, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201006901 Issued in MI

Practice address

1500 E Medical Center Dr
Ann Arbor, MI 48109-0999

Phone

(734) 763-2554

NPI assigned

Apr 26, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25437/brand/1/csg/1/fhir/r4

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.

• Shooting Star Feeding and Swallowing Therapy

  • Pediatric Occupational Therapist
  • Plymouth, MI
  • NPI 1831855071
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891915765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15552 MARILYN AVE",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704838",
            "telephone_number": "734-420-1214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481090999",
            "telephone_number": "734-763-2554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANETTA",
        "first_name": "STACY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201006901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ambarish Pandey, MBBS
• Sheela Pandey, LLMSW
• Amit Pandya, MD
• Kanan S Pandya, PA-S1
• Srushti Pandya
• Judy Chia Pang, MD
• Percival Pangilinan Jr., MD
• Brittany Pannecouk
• Yennifer Pantaleon
• Liron Pantanowitz, MD

• Occupational Therapist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.