Active NPI
Stacey Joyce Churchill, MPT
- Physical Therapist
- Clermont, FL
National Provider Identifier
1932384013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT26441
- Practice address
- 1600 Hunt Trace Blvd
Clermont, FL 34711-5184 - Phone
- (352) 394-5549
- NPI assigned
- Jan 8, 2008
- Last updated
- Sep 30, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11349 | NC | |
| Physical Therapist | 225100000X | PT26441 | FL | Primary |
Addresses
Primary practice location
1600 Hunt Trace Blvd
Clermont, FL 34711-5184
Mailing address
1600 Hunt Trace Blvd
Clermont, FL 34711-5184
Phone (352) 394-5549
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7212335 | Medicaid | NC | |
| 068VV | Other | NC | BCBS OF NC |
Other names 1
- Stacey Joyce Weston
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 |
|---|---|---|---|
| PT26441 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Physical Therapy Solutions LLC | Physical Therapist | Past | Accepting new patients |
Networks
- Freedom Health HMO Network
Organizations & group practices 1
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.
-
- Physical Therapist
- Fayetteville, NC
- NPI 1467405019
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380499200000",
"number": "1932384013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 HUNT TRACE BLVD",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347115184",
"telephone_number": "352-394-5549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 HUNT TRACE BLVD",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347115184",
"telephone_number": "352-394-5549"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHURCHILL",
"first_name": "STACEY",
"middle_name": "JOYCE",
"credential": "MPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-08",
"last_updated": "2013-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "11349",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT26441",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7212335",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF NC",
"identifier": "068VV",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "STACEY",
"last_name": "WESTON",
"middle_name": "JOYCE",
"credential": "MPT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Clermont, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.