Lacey Anne Stalder

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

103167 Issued in AK

Practice address

5993 Coho St
Unit C
Jber, AK 99506-3605

Phone

(231) 557-1240

NPI assigned

Sep 7, 2015

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

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

{
    "created_epoch": "1441584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441584000000",
    "number": "1982072039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5993 COHO ST",
            "address_2": "UNIT C",
            "city": "JBER",
            "state": "AK",
            "postal_code": "995063605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5993 COHO ST",
            "address_2": "UNIT C",
            "city": "JBER",
            "state": "AK",
            "postal_code": "995063605",
            "telephone_number": "231-557-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALDER",
        "first_name": "LACEY",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-07",
        "last_updated": "2015-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AK",
            "license": "103167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna Hope Slayback
• Jennifer Dawn Smith, CNM
• Eldon Snyder, D.O.
• Patrick C Sosa, PHARMD
• Bennett Robert Stadler
• Savannah N Stamates
• Andrew Statkevich, PT, DPT
• Mycala B Stedingh, IDMT
• Dragos Stefan-Dogar, D.D.S.
• Charlton Stevens, MD

• Physical Therapy Assistant in Jber, AK
• Providers in Jber, AK by specialty
• Physical Therapy Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.

Verify at the official NPI Registry.