Active NPI
Kathryn D Micken, P.T.A.
- Physical Therapy Assistant
- Millington, MD
National Provider Identifier
1194003814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A3649
- Practice address
- 124 Red Lion Branch Rd
Millington, MD 21651-1588 - Phone
- (410) 924-7247
- NPI assigned
- Jul 29, 2011
- Last updated
- Jan 9, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | A3649 | MD | Primary |
Addresses
Primary practice location
124 Red Lion Branch Rd
Millington, MD 21651-1588
Mailing address
124 Red Lion Branch Rd
Millington, MD 21651-1588
Phone (410) 924-7247
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 |
|---|---|---|---|
| A3649 | MD | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452297600000",
"number": "1194003814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 RED LION BRANCH RD",
"city": "MILLINGTON",
"state": "MD",
"postal_code": "216511588",
"telephone_number": "410-924-7247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 RED LION BRANCH RD",
"city": "MILLINGTON",
"state": "MD",
"postal_code": "216511588",
"telephone_number": "410-924-7247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICKEN",
"first_name": "KATHRYN",
"middle_name": "D",
"credential": "P.T.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-29",
"last_updated": "2016-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MD",
"license": "A3649",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Millington, MD
- Community Fire Co of Millington Inc.
- Dina Morales Downey, NP
- GK Wright Counseling and Consulting Services, LLC
- Jennifer Dawn Hardin, LCSW-C
- Frank Lewis Jr., M.D.
- Millington Pharmacy Inc (Millington Pharmacy)
- Gabrielle Morgan
- Tracy Nicole Anastasia Olsen-Downey, RN
- Successfully Nurtured Collective LLC (Successfully Nurtured)
- Melanie Elizabeth Tarr, IBCLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.