Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Stacey Marie Boster, MS, PT

Individual provider Physical Therapist · NPI 1053319715

Mrs. Stacey Marie Boster, MS, PT is a Physical Therapist in Private Practice in Russellville, Arkansas. Qualified in 2002, 24 years ago. Practices with Lane Physical Therapy Center, Inc, a 4-clinician group and accepts Medicare assignment. Licensed in Arkansas.

Years since qualifying
24
Licensed in
AR
In the registry since
2005
What do these letters mean?
MS — Master of Science
A graduate science degree.
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

3016 W Main St Ste 200
Russellville, AR 72801
Phone: (479) 967-9657
Fax: (479) 967-9658
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT2554 (AR)

Record details

NPI number1053319715
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , PT
Sole proprietorNo
NPI enumeratedJuly 7, 2005
Last updated in NPPESSeptember 28, 2011

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Lane Physical Therapy Center, Inc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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