Stacy Davis

Key facts

NPI

1912457136

Entity type

Individual (NPI type 1)

Primary specialty

Occupational Therapist 225X00000X

License

OT-A411 (AR)

Practice address

510 Hempstead 173W
Hope, AR 71801

Phone

(870) 703-0607

NPI assigned

Oct 12, 2016

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

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 12, 2016.

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1912457136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 HEMPSTEAD 173W",
            "city": "HOPE",
            "state": "AR",
            "postal_code": "71801",
            "telephone_number": "870-703-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 HEMPSTEAD 173W",
            "city": "HOPE",
            "state": "AR",
            "postal_code": "71801",
            "telephone_number": "870-703-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "STACY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-12",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OT-A411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hope, AR

• Laura Lee Cutler, RN
• April Leann Davis, FNP-BC
• Holly Davis
• Ronald Craig Davis, M.S.
• Shameika M Davis
• Dean S. Butler Hope Physical Therapy Center
• Jessica Renee Dearinger, CASE MANAGER
• Tamara Deloach
• Laura R Douglas, D.C.
• William Ladell Douglas, MD

All providers in Hope, AR · Occupational Therapist in Arkansas