Kimberly D McDougal, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2203 Issued in AR

Practice address

301 Reasoner LN
Russellville, AR 72802-2201

Phone

(479) 970-2175

Fax

(479) 964-2126

NPI assigned

Aug 21, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kimberly D Taylor Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199577600000",
    "number": "1043325640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 REASONER LN",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728022201",
            "telephone_number": "479-970-2175",
            "fax_number": "479-964-2126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 REASONER LN",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728022201",
            "telephone_number": "479-970-2175",
            "fax_number": "479-964-2126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDOUGAL",
        "first_name": "KIMBERLY",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2008-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "2203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "TAYLOR",
            "middle_name": "D",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jayna Michelle McCutcheon
• Lisa McDaniel
• Tosha McDaniel, CMP
• Kamala J McDonald, OT
• Kayla McDonough
• Zoey Danielle McElroy
• Crista McFarland, SHIFT SUPERVISOR
• Marcia McGlone, APRN
• Savannah McKnight
• Garrett McKown, LCSW

• Physical Therapist in Russellville, AR
• Providers in Russellville, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2008; 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.