Caroline M Stanley, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

30890 Issued in FL

Practice address

1200 Hawthorne Hse Dr
Shalimar, FL 32579-1168

Phone

(850) 609-2550

NPI assigned

Apr 19, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Rehabcare Group East, LLC

  • Rehabilitation Clinic/Center
  • Shalimar, FL
  • NPI 1407382278
  NPD (past)

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

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1972184133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 HAWTHORNE HSE DR",
            "city": "SHALIMAR",
            "state": "FL",
            "postal_code": "325791168",
            "telephone_number": "850-609-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 HAWTHORNE HSE DR",
            "city": "SHALIMAR",
            "state": "FL",
            "postal_code": "325791168",
            "telephone_number": "850-609-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "CAROLINE",
        "middle_name": "M",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-19",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "30890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandria Smith
• Lauren Snow, DMD
• Alexander Sorlie, BCABA
• Square Cars LLC.
• Joshua Square
• Carrie Ellen Stapleton, LMHC
• Jennifer Renee Stejskal
• Laura Mae Stephens
• George Andress Stone IV, DMD
• The Healing Impact, Inc

• All providers in Shalimar, FL
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.

Verify at the official NPI Registry.