1124858261 NPI number — STEPH PAULEY THERAPY PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124858261 NPI number — STEPH PAULEY THERAPY PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STEPH PAULEY THERAPY PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124858261
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/10/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 585
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAYBORO
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28515-0585
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
252-285-4726
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2002 S GLENBURNIE RD STE 3A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW BERN
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28562-5230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-285-4726
Provider Business Practice Location Address Fax Number:
202-788-6985
Provider Enumeration Date:
08/05/2024

Additional Information

Authorized Official

Authorized Official Last Name:
PAULEY
Authorized Official First Name:
STEPHANIE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
252-285-4726

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1639896285 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1124858261 . This is a "NPI2" identifier . This identifiers is of the category "OTHER".




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