Individual provider Active NPI

Kim M Lemmons, PTA

  • Physical Therapy Assistant
  • Overland Park, KS
National Provider Identifier
1184877896
Registry record updated Oct 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
857 Issued in NE
Practice address
10300 W 103Rd St
Suite 300
Overland Park, KS 66214-2642
Phone
(913) 894-1910
NPI assigned
Oct 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 857 NE Primary
Physical Therapy Assistant 225200000X 001329 IA

Addresses

Primary practice location

10300 W 103Rd St
Suite 300
Overland Park, KS 66214-2642

Mailing address

6508 S 108TH Ave
Omaha, NE 68137-4713
Phone (402) 212-4501

Other identifiers 2

IdentifierTypeStateIssuer
857OtherNESTATE CERTIFICATE
001329OtherIASTATE LICENSE

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

LicenseStateTypeSpecialty
857NEMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1224806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224806400000",
    "number": "1184877896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6508 S 108TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681374713",
            "telephone_number": "402-212-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 W 103RD ST",
            "address_2": "SUITE 300",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662142642",
            "telephone_number": "913-894-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMMONS",
        "first_name": "KIM",
        "middle_name": "M",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-24",
        "last_updated": "2008-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NE",
            "license": "857",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IA",
            "license": "001329",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE CERTIFICATE",
            "identifier": "857",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "001329",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2008; 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.