Active NPI
Stacey Outridge, MOT, OTR/L
- Occupational Therapist
- Independence, OH
National Provider Identifier
1912466764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 4 Summit Park Dr Ste 350
Independence, OH 44131-6904 - Phone
- (330) 253-8680
- NPI assigned
- Mar 19, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | Primary |
Addresses
Primary practice location
4 Summit Park Dr Ste 350
Independence, OH 44131-6904
Mailing address
1593 Wagar Ave
Lakewood, OH 44107-3640
Phone (216) 798-8972
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730851200000",
"number": "1912466764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1593 WAGAR AVE",
"city": "LAKEWOOD",
"state": "OH",
"postal_code": "441073640",
"telephone_number": "216-798-8972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 SUMMIT PARK DR STE 350",
"city": "INDEPENDENCE",
"state": "OH",
"postal_code": "441316904",
"telephone_number": "330-253-8680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OUTRIDGE",
"first_name": "STACEY",
"credential": "MOT, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-19",
"last_updated": "2024-11-06",
"certification_date": "2024-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Independence, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.