Individual provider Active NPI

Kayley Foster, P.T.

  • Physical Therapist
  • Russellville, AR
National Provider Identifier
1063968071
Registry record updated Dec 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT4211 Issued in AR
Practice address
2100 W Main St
Russellville, AR 72801-2758
Phone
(479) 968-2525
Fax
(479) 968-2538
NPI assigned
Aug 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT4211 AR Primary

Addresses

Primary practice location

2100 W Main St
Russellville, AR 72801-2758

Mailing address

2100 W Main St
Russellville, AR 72801-2758
Phone (479) 968-2525

Other identifiers 4

IdentifierTypeStateIssuer
5BW19OtherARARKANSAS BLUE CROSS BLUE SHIELD
216997721MedicaidAR
A002OtherARTRICARE
710857801OtherARQUALCHOICE

Other names 1

  • Kayley Lawrence Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161205000011 AR Practitioner - Physical Therapist in Private Practice 2668752916 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
River Valley Therapy and Sports Medicine IncGroup PAC ID 1850294018, 31 clinicians

Practice addresses (Care Compare)

2100 W Main St
Russellville, AR 72801-2758
Phone (479) 968-2525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT4211ARMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
River Valley Therapy & Sports Medicine Inc Physical Therapist CurrentSince Aug 25, 2016 Accepting new patients

Locations

2100 W Main St
Russellville, AR 72801
Phone (479) 968-2525

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482969600000",
    "number": "1063968071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 W MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012758",
            "telephone_number": "479-968-2525",
            "fax_number": "479-968-2538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 W MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012758",
            "telephone_number": "479-968-2525",
            "fax_number": "479-968-2538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSTER",
        "first_name": "KAYLEY",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-30",
        "last_updated": "2016-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT4211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS BLUE CROSS BLUE SHIELD",
            "identifier": "5BW19",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "216997721",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "A002",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "710857801",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLEY",
            "last_name": "LAWRENCE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Russellville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.