Active NPI
Kelly M Rentmeister, PTA
- Physical Therapy Assistant
- Vacaville, CA
National Provider Identifier
1104156736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA8876
- Practice address
- 770 Mason St
Vacaville, CA 95688-4646 - Phone
- (707) 454-5990
- Fax
- (707) 454-5991
- NPI assigned
- Jan 4, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA8876 | CA | Primary |
Addresses
Primary practice location
770 Mason St
Vacaville, CA 95688-4646
Mailing address
PO Box 255228
Sacramento, CA 95865-5228
Phone (707) 454-5990
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 |
|---|---|---|---|
| PTA8876 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262563200000",
"number": "1104156736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 255228",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958655228",
"telephone_number": "707-454-5990",
"fax_number": "707-454-5991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "770 MASON ST",
"city": "VACAVILLE",
"state": "CA",
"postal_code": "956884646",
"telephone_number": "707-454-5990",
"fax_number": "707-454-5991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENTMEISTER",
"first_name": "KELLY",
"middle_name": "M",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-04",
"last_updated": "2010-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "PTA8876",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vacaville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.