Active NPI
Carole Bruce Daniel, PTA
- Physical Therapy Assistant
- Fort Smith, AR
National Provider Identifier
1184890758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA 1853
- Practice address
- 3205 Jenny Lind
Fort Smith, AR 72901-6519 - Phone
- (479) 785-2501
- NPI assigned
- May 5, 2008
- 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 1853 | AR | Primary |
Addresses
Primary practice location
3205 Jenny Lind
Fort Smith, AR 72901-6519
Mailing address
2619 S 23Rd St
Fort Smith, AR 72901-6519
Phone (479) 783-2683
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 1853 | AR | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fort Smith School District 100 | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Local Education Agency (LEA)
- Fort Smith, AR
- NPI 1578617171
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210032000000",
"number": "1184890758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2619 S 23RD ST",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729016519",
"telephone_number": "479-783-2683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3205 JENNY LIND",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729016519",
"telephone_number": "479-785-2501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANIEL",
"first_name": "CAROLE",
"middle_name": "BRUCE",
"name_prefix": "Mrs.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-05",
"last_updated": "2008-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AR",
"license": "PTA 1853",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Smith, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.