Kathryn Kelly Anderson, PTA

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

PTA24543 Issued in FL

Practice address

45390 Green Ave
Callahan, FL 32011-3711

Phone

(904) 879-1223

Fax

(904) 879-4986

NPI assigned

Feb 7, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Nassau Physical Therapy Inc

  • Specialist
  • Callahan, FL
  • NPI 1487872651
  NPD (past)

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

{
    "created_epoch": "1517961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1023517828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1609",
            "city": "CALLAHAN",
            "state": "FL",
            "postal_code": "320111609",
            "telephone_number": "904-879-1223",
            "fax_number": "904-979-4986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45390 GREEN AVE",
            "city": "CALLAHAN",
            "state": "FL",
            "postal_code": "320113711",
            "telephone_number": "904-879-1223",
            "fax_number": "904-879-4986"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1885 S 14th St",
            "address_purpose": "LOCATION",
            "city": "Fernandina Beach",
            "state": "FL",
            "postal_code": "320343033",
            "country_code": "US",
            "telephone_number": "904-277-4449",
            "fax_number": "904-277-4177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KATHRYN",
        "middle_name": "KELLY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "PTA24543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A-1 Transportation Inc.
• Nikki M Abernathy, NLMT
• Achieve Behavioral Services
• Faith Ann Adams, APRN
• Shuaib Akbari, PTA
• Victoria Anderson
• Danielle Austin
• Juan Avelino, DPT
• Jaleesa Bachmann
• Baptist Primary Care Inc

• Physical Medicine & Rehabilitation Physician in Callahan, FL
• Providers in Callahan, FL by specialty
• Physical Medicine & Rehabilitation Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.