STACEY MICHELE PHILLIPS (NPI# 1053558494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053558494 |
| Entity Type | Individual |
| Full Name | STACEY MICHELE PHILLIPS |
| Credential | MS, PT |
| Practice Address |
46 W Colt Square Dr Fayetteville AR 72703-2813 |
| Practice Telephone | 4795822740 |
| Practice Fax Number | 4795822746 |
| Mailing Telephone | 4795822740 |
| Mailing Fax Number | 4795822746 |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2009-01-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
PT 2212 | AR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 135927721 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073051256 | Stacey L Phillips | Early Intervention Provider Agency | 185 Bronx River Rd, 4p, Yonkers, NY 10704-3752 | 2017-02-07 |
| 1730237926 | Stacey Marie Phillips | Speech-Language Pathologist | 1604 W Cullom Ave, Apt #2wc, Chicago, IL 60613-1255 | 2007-01-06 |
| 1679950877 | Stacey Phillips | Social Worker | 2609 N Duke St, Suite 504, Durham, NC 27704-3048 | 2015-04-27 |
| 1801237888 | Stacey Ann Marie Phillips | Licensed Practical Nurse | 40700 California Oaks Rd, Suite 202, Murrieta, CA 92562-5795 | 2013-07-08 |
| 1083912653 | Stacey Jo Phillips | Case Manager/Care Coordinator | 5965 S 900 E, Salt Lake City, UT 84121-1720 | 2011-03-07 |
| 1710136718 | Stacey Lynn Phillips | Nurse Practitioner | 25 Woodbridge Rd, Suite A, Somerville, TN 38068-1242 | 2008-09-15 |
| Street Address |
46 W COLT SQUARE DR |
| City | FAYETTEVILLE |
| State | AR |
| Zip Code | 72703-2813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578713962 | Lynn Ann Tierney | Occupational Therapist | 46 W Colt Square Dr, Fayetteville, AR 72703-2813 | 2008-09-23 |
| 1831322692 | Ruth Nichols Jeffries | Occupational Therapist | 46 W Colt Square Dr, Fayetteville, AR 72703-2813 | 2009-08-27 |
| 1518192103 | Tarah Nicole Holman | Occupational Therapist | 46 W Colt Square Dr, Fayetteville, AR 72703-2813 | 2009-05-26 |
| 1306080783 | Barbra Ellen Anderson | Occupational Therapist | 46 W Colt Square Dr, Fayetteville, AR 72703-2813 | 2009-04-29 |
| 1215183959 | Kristy Kay Burnett | Speech-Language Pathologist | 46 W Colt Square Dr, Fayetteville, AR 72703-2813 | 2008-08-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154391 | Margaret Sorrells | Pharmacist | 3909 N Mall Ave Attn:pharmacy, Fayetteville, AR 72703 | 2020-11-06 |
| 1497369631 | Justin A Rand | Massage Therapist | 88 W Colt Square Dr, Fayetteville, Ar 72703, Fayetteville, AR 72703 | 2020-09-04 |
| 1235777558 | Washington Regional Medical System | Specialist | 3264 N North Hills Blvd, Fayetteville, AR 72703 | 2019-12-17 |
| 1760024582 | Haley Brooke Thompson | Occupational Therapist | 2474 E Joyce Blvd Ste 2, Null, Fayetteville, AR 72703 | 2019-10-14 |
| 1306492129 | Bhg L, LLC | Clinic/Center | 8 Colt Square Drive, Fayetteville, AR 72703 | 2019-08-16 |
| 1306406269 | Idell Marie Mitchell | Optometrist | Eye Clinic, 1100 N College Ave, Fayetteville, AR 72703 | 2019-06-13 |
| 1821574815 | Toni Myer | Nurse Practitioner | 3 E Appleby Rd Ste 101, Fayetteville, AR 72703 | 2018-07-13 |
| 1306340393 | Josh Kelfer | Student in an Organized Health Care Education/Training Program | 1125 North College Avenue, Fayetteville, AR 72703 | 2018-03-22 |
| 1649726449 | Vantage Point of Nwa | Community/Behavioral Health | 4171 N. Crossover Rd, Fayetteville, AR 72703 | 2016-08-31 |
| 1386097137 | Jason Nordstrom | Speech-Language Pathologist | 2664 N Valencia Ave, Fayetteville, AR 72703 | 2016-07-18 |
| Find all providers in zip 72703 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780069476 | Edith Areli Molina Amaya | Physical Therapist | 2819 W Hillshire Dr, Fayetteville, AR 72704-5137 | 2015-07-23 |
| 1306104773 | Cheryl F. Borden | Physical Therapist | 4216 Bartlet Glen Ln, Fayetteville, NC 28306-9357 | 2012-04-24 |
| 1730470998 | Stefanie Hines Schumacher | Physical Therapist | 48 Colt Square, Fayetteville, AR 72703-2813 | 2011-04-22 |
| 1578702676 | Marla Cohen | Physical Therapist | 5201 Hoag Ln, Fayetteville, NY 13066-2508 | 2009-02-12 |
| 1245491224 | The Therapy Spot,llc | Physical Therapist | 3130 Market St., Fayetteville, AR 72703-7519 | 2008-06-22 |
| 1376717249 | Tammy Lee Heino | Physical Therapist | 6836 Holliston Cir, Fayetteville, NY 13066-1700 | 2008-04-22 |
| 1730375650 | Christie Summerford | Physical Therapist | 2474 E. Joyce Blvd, Suite 2, Fayetteville, AR 72703 | 2007-09-25 |
| 1528031275 | Shanna Scott Thurman | Physical Therapist | 5310 Yadkin Rd, Fayetteville, NC 28303-3255 | 2006-02-10 |
| 1902454507 | Southeastern Motor and Sensory Specialists | Physical Therapist | 3530 Boone Trl, Fayetteville, NC 28306-2189 | 2019-08-28 |
| 1609301811 | Erin Elaine Calvelage | Physical Therapist | 3801 Johnson Mill Blvd, Fayetteville, AR 72704-5297 | 2017-04-25 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 72703 |
Please comment or provide details below to improve the information on STACEY MICHELE PHILLIPS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.