Kathleen Sison Azcona, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070016179 Issued in IL

Practice address

11197 SW Springtree Ter
Port Saint Lucie, FL 34987-2733

Phone

(703) 220-2476

NPI assigned

Jun 24, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Kathleen Mercado Sison Former name

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": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438732800000",
    "number": "1124289954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11197 SW SPRINGTREE TER",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349872733",
            "telephone_number": "703-220-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11197 SW SPRINGTREE TER",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349872733",
            "telephone_number": "703-220-2476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZCONA",
        "first_name": "KATHLEEN",
        "middle_name": "SISON",
        "name_prefix": "Miss",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-24",
        "last_updated": "2015-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070016179",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "24432",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "SISON",
            "middle_name": "MERCADO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2015; 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.