Stacy L Hannemann, OT

Primary specialty

Hand Occupational TherapistTaxonomy code 225XH1200X

License

OT-1767 Issued in ID

Practice address

10573 N Friar Dr Apt a
Hayden, ID 83835-8507

Phone

(661) 373-1118

NPI assigned

May 3, 2006

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

Other names 1

• Stacy Lynn Jensen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Ironwood Drive Physical Therapy, PA

  • Physical Therapist
  • Coeur D Alene, ID
  • NPI 1801812482
  NPD (past)
• Hagar & Richter

  • Occupational Therapist
  • Valencia, CA
  • NPI 1508834979
  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1992763536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10573 N FRIAR DR APT A",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838358507",
            "telephone_number": "661-373-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10573 N FRIAR DR APT A",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838358507",
            "telephone_number": "661-373-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNEMANN",
        "first_name": "STACY",
        "middle_name": "L",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "ID",
            "license": "OT-1767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "JENSEN",
            "middle_name": "LYNN",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christopher Michael Hackett, D.C.
• Riley Cole Halligan, BCBA
• Clois Paul Hancock, LMT, NAC
• Philip A Hanger, PH.D
• Marty J Hann, DDS
• Scott Hansen
• Robin Happeny, LCSW
• Lea B Harger, LCSW
• Kristlyn Delainey Harrington
• Haven Therapy LLC

• All providers in Hayden, ID
• Hand Occupational Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; 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.