Individual provider Active NPI

Dolores Carol Quick, PTA

  • Physical Therapy Assistant
  • Cookeville, TN
National Provider Identifier
1235384512
Registry record updated Nov 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
4406 Issued in TN
Practice address
815 S Walnut Ave
Cookeville, TN 38501-5956
Phone
(931) 528-5516
NPI assigned
Nov 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 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 4406 TN Primary
Physical Therapy Assistant 225200000X 19533 FL

Addresses

Primary practice location

815 S Walnut Ave
Cookeville, TN 38501-5956

Mailing address

432 Maddux Rd
Cookeville, TN 38501-9705
Phone (931) 525-6894

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
19533FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1228003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228003200000",
    "number": "1235384512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 MADDUX RD",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385019705",
            "telephone_number": "931-525-6894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 S WALNUT AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385015956",
            "telephone_number": "931-528-5516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUICK",
        "first_name": "DOLORES",
        "middle_name": "CAROL",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-30",
        "last_updated": "2008-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "4406",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "19533",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.