Active NPI
Vibha M Patel, PTA
- Physical Therapy Assistant
- Pine Bluff, AR
National Provider Identifier
1174829683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA 2066
- Practice address
- 1600 W 40TH Ave
Pine Bluff, AR 71603-6301 - Phone
- (870) 541-8776
- NPI assigned
- Jan 31, 2011
- 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 | PTA 2066 | AR | Primary |
Addresses
Primary practice location
1600 W 40TH Ave
Pine Bluff, AR 71603-6301
Mailing address
805 Sandstone Cir Apt 7
Russellville, AR 72802-7109
Phone (479) 498-2045
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 |
|---|---|---|---|
| PTA 2066 | AR | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296518400000",
"number": "1174829683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 SANDSTONE CIR APT 7",
"city": "RUSSELLVILLE",
"state": "AR",
"postal_code": "728027109",
"telephone_number": "479-498-2045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 W 40TH AVE",
"city": "PINE BLUFF",
"state": "AR",
"postal_code": "716036301",
"telephone_number": "870-541-8776"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "VIBHA",
"middle_name": "M",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-31",
"last_updated": "2011-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AR",
"license": "PTA 2066",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pine Bluff, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.