Michelle Stoecker, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070022602 Issued in IL

Practice address

2338 W Van Winkle Way
Peoria, IL 61615-7483

Phone

(309) 693-9189

NPI assigned

Oct 21, 2016

Last updated

Oct 21, 2016By the provider in NPPES

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

Other names 1

• Michelle Ditmars Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1477008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477008000000",
    "number": "1902357254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 NE MADISON AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021109",
            "telephone_number": "309-674-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2338 W VAN WINKLE WAY",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157483",
            "telephone_number": "309-693-9189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOECKER",
        "first_name": "MICHELLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-21",
        "last_updated": "2016-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070022602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "DITMARS",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gabriel J Stickling, O.T.
• Courtney Leigh Stivers, PHD, LMFT
• Ryan Joseph Stivers, PH.D., LMFT, LPC
• Adam John Stocksiek
• Joseph S Stocksiek
• Jessica Christine Stokowski, RN, IBCLC
• Ryan Stoller
• Charne Stoltz
• Edith Stolz, LPC
• Stone Bridge Counseling LLC

• Physical Therapist in Peoria, IL
• Providers in Peoria, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; 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.