Active NPI
Stacy Anne Goleburn, P.T.
- Physical Therapist
- Boca Raton, FL
National Provider Identifier
1922325182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT23868
- Practice address
- 880 NW 13TH St
Boca Raton, FL 33486-2342 - Phone
- (561) 955-0028
- Fax
- (561) 828-3139
- NPI assigned
- Apr 28, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT23868 | FL | Primary |
Addresses
Primary practice location
880 NW 13TH St
Boca Raton, FL 33486-2342
Mailing address
7765 Courtyard Run W
Boca Raton, FL 33433-3022
Phone (847) 363-3700
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT23868 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272412800000",
"number": "1922325182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7765 COURTYARD RUN W",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334333022",
"telephone_number": "847-363-3700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "880 NW 13TH ST",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334862342",
"telephone_number": "561-955-0028",
"fax_number": "561-828-3139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLEBURN",
"first_name": "STACY",
"middle_name": "ANNE",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-04-28",
"last_updated": "2010-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT23868",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boca Raton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.