Active NPI
Megan Anne Bald, PTA
- Physical Therapy Assistant
- Merritt Island, FL
National Provider Identifier
1053747477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A4821
- Practice address
- 750 Oak Park Cir
Merritt Island, FL 32953-4158 - Phone
- (954) 295-7680
- NPI assigned
- Sep 17, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A4821 | NC | Primary |
Addresses
Primary practice location
750 Oak Park Cir
Merritt Island, FL 32953-4158
Mailing address
750 Oak Park Cir
Merritt Island, FL 32953-4158
Phone (954) 295-7680
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A4821 | NC | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Healthcare Services, Inc. | Past | Accepting new patients | |
| Legacy Healthcare Services | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Skilled Nursing Facility
- Raleigh, NC
- NPI 1346490489
-
- Physical Therapist
- Durham, NC
- NPI 1104823400
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563840000000",
"number": "1053747477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "750 OAK PARK CIR",
"city": "MERRITT ISLAND",
"state": "FL",
"postal_code": "329534158",
"telephone_number": "954-295-7680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 OAK PARK CIR",
"city": "MERRITT ISLAND",
"state": "FL",
"postal_code": "329534158",
"telephone_number": "954-295-7680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALD",
"first_name": "MEGAN",
"middle_name": "ANNE",
"name_prefix": "Mrs.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-17",
"last_updated": "2019-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NC",
"license": "A4821",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Merritt Island, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.