Temesgen Alem Kidane, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

30969 Issued in FL

Practice address

4125 Hunters Park LN Ste 116
Orlando, FL 32837-7615

Phone

(407) 855-0614

NPI assigned

Apr 16, 2021

Sex

Male

Sole proprietor

Yes

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.

• Cora Health Services Inc

  dba CORA Physical Therapy - Hunter's Creek

  • Rehabilitation Clinic/Center
  • Orlando, FL
  • NPI 1043243215
  NPD (past)
• Cora Health Services, Inc

  dba CORA Physical Therapy-Stoneybrook

  • Rehabilitation Clinic/Center
  • Winter Garden, FL
  • NPI 1104786805
  NPD (past)

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

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1063093482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 SHAWNEE RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458053529",
            "telephone_number": "419-221-6715",
            "fax_number": "866-675-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 HUNTERS PARK LN STE 116",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328377615",
            "telephone_number": "407-855-0614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDANE",
        "first_name": "TEMESGEN",
        "middle_name": "ALEM",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-16",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "30969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arupa Yashswini Khusial, M.D.
• Elizabeth Anne Kibodeaux, DO
• Whitney Degraff Kicklighter, LMHC
• Kid Continuum LLC
• Kid's Therapy Land Bilingual Speech LLC
• Geraldine Kidary, ARNP
• Kidney Care LLC
• Kidoz Therapy Zone LLC
• Kids Neuro Care LLC
• Kids Therapy ABA LLC

• Physical Therapy Assistant in Orlando, FL
• Providers in Orlando, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.