Stacy Elizabeth Justice, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT5031 Issued in AR

Practice address

1200 Old Warren Rd
Monticello, AR 71655-9723

Phone

(870) 367-1548

Fax

(870) 367-1383

NPI assigned

Aug 18, 2021

Last updated

Aug 18, 2021By 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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Arkansas Rehabilitation IncGroup PAC ID 1052414968, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South Arkansas Rehabilitation, Inc.

  • Physical Therapist
  • Monticello, AR
  • NPI 1295882843
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1629244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1912673187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 OLD WARREN RD",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716559723",
            "telephone_number": "870-367-1548",
            "fax_number": "870-367-1383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 OLD WARREN RD",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716559723",
            "telephone_number": "870-367-1548",
            "fax_number": "870-367-1383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTICE",
        "first_name": "STACY",
        "middle_name": "ELIZABETH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-18",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT5031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "PT5031",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Candace N Jordan, MS, OTR/L
• David B Jordan, MHPP
• Tincy Jordan, OT
• Joseph P. Miles, DDS, PA
• Helen Regina Junior
• Kah Development 4, LLC (CenterWell Home Health)
• Ashley Deshea Kelnhofer, MS, CCC-SLP
• Angelia Grace Kidwell, PTA
• Lisa Kilcrease, LCSW
• Lesa Kilpatrick, LCSW

• Physical Therapist in Monticello, AR
• Providers in Monticello, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.