James Robert Medlyn, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA1787 Issued in AR

Practice address

117 Northridge Dr E Ste C
Van Buren, AR 72956-5183

Phone

(479) 474-4892

NPI assigned

Sep 20, 2024

Sex

Male

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

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

{
    "created_epoch": "1726790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1033936109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3302 S 97TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035712",
            "telephone_number": "479-459-7077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 NORTHRIDGE DR E STE C",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729565183",
            "telephone_number": "479-474-4892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDLYN",
        "first_name": "JAMES",
        "middle_name": "ROBERT",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-20",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "PTA1787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa K McGraw, MD
• Matthew B McLellan, MD
• Addison Hope McMillan
• Grayson McReynolds, DDS
• Nicole Medina, LCSW
• Angie Melgar
• Memory Lane, Inc.
• Winter Mendenhall
• Tanya Renee Merrill, PHYSICALTHERAPY ASST
• Kristen Nicole Meyer

• Physical Therapy Assistant in Van Buren, AR
• Providers in Van Buren, AR by specialty
• Physical Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.