Active NPI
Kimberly Davis, P.T.A
- Physical Therapy Assistant
- Arlington, TX
National Provider Identifier
1093919110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 1975
- Practice address
- 306 E Randol Mill Rd Ste 100
Arlington, TX 76011-5841 - Phone
- (817) 461-0154
- Fax
- (817) 275-9792
- NPI assigned
- Jun 13, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2051150 | TX | |
| Physical Therapy Assistant | 225200000X | 1975 | OK | Primary |
Addresses
Primary practice location
306 E Randol Mill Rd Ste 100
Arlington, TX 76011-5841
Mailing address
19307 E 105TH St S
Broken Arrow, OK 74014-3504
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 |
|---|---|---|---|
| 1975 | OK | MD | Professional Counselor |
| 2051150 | TX | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rosa'S First Quality Home Healthcare LLC | Past | Accepting new patients |
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.
-
- Home Health Agency
- Arlington, TX
- NPI 1518968106
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291075200000",
"number": "1093919110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19307 E 105TH ST S",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740143504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 E RANDOL MILL RD STE 100",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "760115841",
"telephone_number": "817-461-0154",
"fax_number": "817-275-9792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "KIMBERLY",
"credential": "P.T.A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-13",
"last_updated": "2010-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2051150",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OK",
"license": "1975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arlington, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.