Katie McColley, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA23240 Issued in FL

Practice address

9085 Town Center Pkwy
Lakewood Ranch, FL 34202-4175

Phone

(919) 425-5080

NPI assigned

Jan 25, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1453680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1114384963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9011 59TH AVENUE CIR E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342029665",
            "telephone_number": "570-854-9402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9085 TOWN CENTER PKWY",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342024175",
            "telephone_number": "919-425-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLEY",
        "first_name": "KATIE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-25",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA23240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryant Maxwell
• Olena May, MS, LDN, CNS
• Ruth McAllister, APRN, PMHNP-BC
• Amanda Leigh McCaw, PSY.D.
• Chancelor McColley, PA-C
• Reese Melina McCorry
• Jennifer R McCullen, MD
• Drew McCullough
• Carlissa Jahnae McFarland
• Claire Ellen McGill, D.O.

• Physical Therapy Assistant in Lakewood Ranch, FL
• Providers in Lakewood Ranch, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; 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.