Individual provider Active NPI

Kristin Marie Jones, PTA

  • Physical Therapy Assistant
  • Springdale, AR
National Provider Identifier
1104306000
Registry record updated Sep 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
4385 Issued in AR
Practice address
6815 Isaacs Orchard Rd Ste D
Springdale, AR 72762-6285
Phone
(479) 856-6400
NPI assigned
Aug 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2018

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 4385 AR Primary

Addresses

Primary practice location

6815 Isaacs Orchard Rd Ste D
Springdale, AR 72762-6285

Mailing address

20251 Dawn Hill East Rd
Gentry, AR 72734-9380
Phone (479) 595-2684

Other practice location 1

1409 Highway 62 65 N Ste 4
Harrison, AR 72601-1970
Phone (870) 704-4076

Other names 1

  • Kristin Marie Showalter Former name

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
4385ARMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1104306000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20251 DAWN HILL EAST RD",
            "city": "GENTRY",
            "state": "AR",
            "postal_code": "727349380",
            "telephone_number": "479-595-2684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6815 ISAACS ORCHARD RD STE D",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727626285",
            "telephone_number": "479-856-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1409 Highway 62 65 N Ste 4",
            "address_purpose": "LOCATION",
            "city": "Harrison",
            "state": "AR",
            "postal_code": "726011970",
            "country_code": "US",
            "telephone_number": "870-704-4076",
            "fax_number": "870-741-0089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-20",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "4385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "SHOWALTER",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springdale, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; 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.