Active NPI
Stacy Frome Christian, DPT
- Geriatric Physical Therapist
- Hurricane, WV
National Provider Identifier
1982736021
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- 1991
- Practice address
- 4000 Out Look Dr
Hurricane, WV 25526-9467 - Phone
- (304) 757-4102
- NPI assigned
- Mar 12, 2007
- Last updated
- Jul 25, 2011
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | 1991 | WV | Primary |
Addresses
Primary practice location
4000 Out Look Dr
Hurricane, WV 25526-9467
Mailing address
4000 Out Look Dr
Hurricane, WV 25526-9467
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5510 Maccorkle Ave SE
Charleston, WV 25304-2320
Phone (304) 720-5433
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1991 | WV | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DPT, Inc | Geriatrics | Current | Accepting new patients |
| Charleston Surgical Hospital Healthcare Group, PLLC | Past | Accepting new patients | |
| Dynamic Physical Therapy and Hand Center, LLC | Past | Accepting new patients |
Locations
5510 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 720-5433
Organizations & group practices 3
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.
-
- Surgery Physician
- Charleston, WV
- NPI 1285131144
-
- Physical Therapist
- Charleston, WV
- NPI 1780781971
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311552000000",
"number": "1982736021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4000 OUT LOOK DR",
"city": "HURRICANE",
"state": "WV",
"postal_code": "255269467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4000 OUT LOOK DR",
"city": "HURRICANE",
"state": "WV",
"postal_code": "255269467",
"telephone_number": "304-757-4102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHRISTIAN",
"first_name": "STACY",
"middle_name": "FROME",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-12",
"last_updated": "2011-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "WV",
"license": "1991",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hurricane, WV
- Charleston Area Medical Center, Inc.
- Charleston Area Medical Center, Inc.
- Charleston Area Medical Center, Inc.
- Charleston Area Medical Ctr - Teays Valley (CAMC Teays Valley Hospital)
- Chiropractic Physicians of West Virginia
- John Mirrell Clark, MD
- Bruce E Clay, MA
- Louise Cleek
- Tamara R Cline, LMT
- Megan L Cobb, PTA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2011; 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.