Active NPI
Stacea Nielsen
- Occupational Therapist
- Clinton, IA
National Provider Identifier
1932794310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 106352
- Practice address
- 849 13TH Ave N
Clinton, IA 52732-5168 - Phone
- (563) 242-1521
- NPI assigned
- Mar 7, 2021
- 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 | 106352 | IA | Primary |
Addresses
Primary practice location
849 13TH Ave N
Clinton, IA 52732-5168
Mailing address
1221 4TH St
Camanche, IA 52730-2119
Phone (563) 249-3217
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 106352 | IA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615075200000",
"number": "1932794310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1221 4TH ST",
"city": "CAMANCHE",
"state": "IA",
"postal_code": "527302119",
"telephone_number": "563-249-3217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "849 13TH AVE N",
"city": "CLINTON",
"state": "IA",
"postal_code": "527325168",
"telephone_number": "563-242-1521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIELSEN",
"first_name": "STACEA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-07",
"last_updated": "2021-03-07",
"certification_date": "2021-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IA",
"license": "106352",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.