Individual provider Active NPI

Stacy Burrell, MS, OTR/L

  • Occupational Therapist
  • West Chazy, NY
National Provider Identifier
1952554727
Registry record updated Sep 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
015091-1 Issued in NY
Practice address
37 Eagle Way
West Chazy, NY 12992-2562
Phone
(518) 563-8035
Fax
(518) 563-8087
NPI assigned
Oct 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 015091-1 NY Primary

Addresses

Primary practice location

37 Eagle Way
West Chazy, NY 12992-2562

Mailing address

37 Eagle Way
West Chazy, NY 12992-2562
Phone (518) 563-8035

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
015091-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Beekmantown Central School District Past Accepting new patients
Beekmantown Central School District Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1224806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284595200000",
    "number": "1952554727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 EAGLE WAY",
            "city": "WEST CHAZY",
            "state": "NY",
            "postal_code": "129922562",
            "telephone_number": "518-563-8035",
            "fax_number": "518-563-8087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 EAGLE WAY",
            "city": "WEST CHAZY",
            "state": "NY",
            "postal_code": "129922562",
            "telephone_number": "518-563-8035",
            "fax_number": "518-563-8087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRELL",
        "first_name": "STACY",
        "name_prefix": "Mrs.",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-24",
        "last_updated": "2010-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "015091-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chazy, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.

Verify at the official NPI Registry.