Active NPI
Mary Underwood
- Physical Therapy Assistant
- Lexington, KY
National Provider Identifier
1114533692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A04134
- Practice address
- 1096 Wellington Way Ste 110
Lexington, KY 40513-1200 - Phone
- (850) 303-6393
- NPI assigned
- Sep 19, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A04134 | KY | Primary |
Addresses
Primary practice location
1096 Wellington Way Ste 110
Lexington, KY 40513-1200
Mailing address
2109 Palomar Trace Dr
Lexington, KY 40513-1120
Phone (859) 492-2063
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 |
|---|---|---|---|
| A04134 | KY | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600473600000",
"number": "1114533692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2109 PALOMAR TRACE DR",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405131120",
"telephone_number": "859-492-2063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1096 WELLINGTON WAY STE 110",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405131200",
"telephone_number": "850-303-6393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UNDERWOOD",
"first_name": "MARY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-19",
"last_updated": "2020-09-19",
"certification_date": "2020-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "KY",
"license": "A04134",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
- Ultrasound Consulting Services, Inc. Dba Patient Choice Ultrasound & Thermography
- Stephen C. Umansky, M.D.
- Umr Lab LLC
- Deana M. Underwood, APRN
- Jessica Underwood, MSOT/L
- Sarah Underwood, RBT
- William Lewayne Underwood, MD
- Richard Zackary Unger, M.D.
- Unify Home Care LLC
- United Behavioral Health Associates, PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.