Active NPI
Stacey Ingram
- Physical Therapist
- Palm Harbor, FL
National Provider Identifier
1942639737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT20309
- Practice address
- 34990 US Hwy 19 North
Palm Harbor, FL 34684 - Phone
- (727) 210-0760
- NPI assigned
- Nov 2, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT20309 | FL | Primary |
Addresses
Primary practice location
34990 US Hwy 19 North
Palm Harbor, FL 34684
Mailing address
34990 US Highway 19 N
Palm Harbor, FL 34684-1920
Phone (727) 210-0760
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 |
|---|---|---|---|
| PT20309 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physiotherapy Associates Inc | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Physical Therapy Clinic/Center
- Estero, FL
- NPI 1720039902
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448409600000",
"number": "1942639737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34990 US HIGHWAY 19 N",
"city": "PALM HARBOR",
"state": "FL",
"postal_code": "346841920",
"telephone_number": "727-210-0760",
"fax_number": "727-210-0761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34990 US HWY 19 NORTH",
"city": "PALM HARBOR",
"state": "FL",
"postal_code": "34684",
"telephone_number": "727-210-0760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INGRAM",
"first_name": "STACEY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-11-02",
"last_updated": "2015-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT20309",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Harbor, FL
- Brooke Aleah Ianiero, DPT
- Marie Graf Ibrahim, RDN
- Marina Ibrahim, PHARMD.
- Impact Health and Performance, LLC
- Judith Brantley Inghram, BCBA
- Inner Peace Counseling & Wellness
- Innovative Care Network LLC
- Innovative Wellness, Inc.
- Insight Spine LLC
- Integrated Regional Laboratories Pathology Services, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.