Individual provider Active NPI

Katelin Kirtland, LPTA

  • Physical Therapy Assistant
  • Gadsden, AL
National Provider Identifier
1093353419
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA9611 Issued in AL
Practice address
2301 Rainbow Dr
Gadsden, AL 35901-5517
Phone
(256) 543-3467
NPI assigned
Dec 16, 2019
Last updated
Dec 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 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 PTA9611 AL Primary

Addresses

Primary practice location

2301 Rainbow Dr
Gadsden, AL 35901-5517

Mailing address

900 Hammonds Rd
Fyffe, AL 35971-3358
Phone (256) 601-7909

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
PTA9611ALMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1576454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1093353419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 HAMMONDS RD",
            "city": "FYFFE",
            "state": "AL",
            "postal_code": "359713358",
            "telephone_number": "256-601-7909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 RAINBOW DR",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359015517",
            "telephone_number": "256-543-3467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRTLAND",
        "first_name": "KATELIN",
        "name_prefix": "Miss",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-16",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AL",
            "license": "PTA9611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gadsden, AL

Sources for this page

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