Individual provider Active NPI

Kayla Ann Canaguier, PTA

  • Physical Therapy Assistant
  • Longview, TX
National Provider Identifier
1073155859
Registry record updated Oct 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2148008 Issued in TX
Practice address
701 E Loop 281
Longview, TX 75605-5006
Phone
(430) 240-4600
NPI assigned
Oct 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2148008 TX Primary

Addresses

Primary practice location

701 E Loop 281
Longview, TX 75605-5006

Mailing address

2266 Mustang Rd
Gilmer, TX 75645-2782

Other practice location 1

703 Titus St
Gilmer, TX 75644-1738
Phone (903) 843-5529

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

LicenseStateTypeSpecialty
2148008TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1570838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570838400000",
    "number": "1073155859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2266 MUSTANG RD",
            "city": "GILMER",
            "state": "TX",
            "postal_code": "756452782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E LOOP 281",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055006",
            "telephone_number": "430-240-4600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "703 Titus St",
            "address_purpose": "LOCATION",
            "city": "Gilmer",
            "state": "TX",
            "postal_code": "756441738",
            "country_code": "US",
            "telephone_number": "903-843-5529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANAGUIER",
        "first_name": "KAYLA",
        "middle_name": "ANN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-12",
        "last_updated": "2019-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2148008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.

Verify at the official NPI Registry.