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NPI Code Detail

MEDICARE: MRS. TIFFANY R STOOTS OTR/L, CHT

MEDICARE: MRS. TIFFANY R STOOTS OTR/L, CHT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist3725TN
2225XH1200XHand Occupational Therapist31008674AIN
3225XH1200XHand Occupational Therapist173085KY
4225XH1200XHand Occupational Therapist2021023097MO
5225XP0019XPhysical Rehabilitation Occupational Therapist3309AL
6225X00000XOccupational Therapist104876MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12021023097OTHERMOLICENSE
231008674AOTHERINLICENSE

General Provider Information

NPI Number : 1467655829
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TIFFANY R STOOTS OTR/L, CHT
Provider Business Mailing Address
First Line : 9302 N MERIDIAN ST STE 190
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46260-1818
Country : US
Telephone Number : 317-843-1270
Fax Number :
Provider Business Practice Location Address
First Line : 9302 N MERIDIAN ST STE 190
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46260-1818
Country : US
Telephone Number : 317-843-1270
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2007
Last Update Date : 01/23/2026

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