Carley Michelle Anderson, PTA

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2162102 Issued in TX

Practice address

3401 Amador Dr
Fort Worth, TX 76177-2227

Phone

(682) 204-0853

NPI assigned

Apr 23, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1114145331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12880 NS 3590",
            "city": "WEWOKA",
            "state": "OK",
            "postal_code": "748845402",
            "telephone_number": "405-398-4761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 AMADOR DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761772227",
            "telephone_number": "682-204-0853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CARLEY",
        "middle_name": "MICHELLE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "NONE",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "2162102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherald G. Anderson-Vogt, LCSW
• Aiyanna B Anderson, M.D.
• Allison Anderson, LPC
• Ashley Anderson
• Brenda Evette Anderson
• Carol Anderson
• Christine Lee Anderson, M.D.
• Cody Lashay Anderson, RN
• Denise Carol Anderson, C.D.E.
• Elisabeth D. Anderson, R.D.

• Physical Therapist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; 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.