Individual provider Active NPI

Stacey L Humes, OTR L

  • Occupational Therapist
  • Carlisle, PA
National Provider Identifier
1982699989
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OC002500L Issued in PA
Practice address
850 Walnut Bottom Rd Ste 306
Carlisle, PA 17013-3615
Phone
(717) 877-8811
Fax
(717) 918-5745
NPI assigned
Sep 15, 2005
Last updated
Mar 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OC002500L PA Primary
Hand Occupational Therapist 225XH1200X 7472 SC
Hand Occupational Therapist 225XH1200X

Addresses

Primary practice location

850 Walnut Bottom Rd Ste 306
Carlisle, PA 17013-3615

Mailing address

PO Box 23
Enola, PA 17025-0023
Phone (717) 877-8811

Other identifiers 4

IdentifierTypeStateIssuer
3571011OtherPAAETNA HMO
7600575OtherPAAETNA PPO
50012506OtherPACAPITAL BLUE CROSS
76210OtherPAHEALTH AMERICA COVENTRY H

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250317000592 SC Practitioner - Occupational Therapist in Private Practice 3577531946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Carolina Sports Medicine and Orthopaedic CenterGroup PAC ID 8527972637, 43 clinicians

Practice addresses (Care Compare)

2760 Tricom St
North Charleston, SC 29406-9169
Phone (843) 300-8585

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Sports Medicine & Orthopaedic Center CurrentSince Feb 10, 2025 Accepting new patients
Donine M. Shaffer Occupational Therapist PastSince Apr 1, 2002 Accepting new patients

Locations

2760 Tricom St
North Charleston, SC 29406
Phone (843) 300-8585

9100 Medcom St
North Charleston, SC 29406
Phone (843) 569-3367

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1516/brand/1/csg/1/fhir/r4
  • Direct secure messaging: stacey.humes.1@1516.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1982699989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23",
            "city": "ENOLA",
            "state": "PA",
            "postal_code": "170250023",
            "telephone_number": "717-877-8811",
            "fax_number": "717-732-0178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 WALNUT BOTTOM RD STE 306",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170133615",
            "telephone_number": "717-877-8811",
            "fax_number": "717-918-5745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMES",
        "first_name": "STACEY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "OTR L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-15",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC002500L",
            "primary": true
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "SC",
            "license": "7472",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3571011",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7600575",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50012506",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA COVENTRY H",
            "identifier": "76210",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlisle, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.