Kimberly A Roach, D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

07573 Issued in LA

Practice address

1316 East Kentucky Ave
Ruston, LA 71270

Phone

(318) 224-9081

Fax

(318) 224-9083

NPI assigned

Jun 9, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Firm Foundation Pediatric Ther

  • Speech/Language/Hearing Specialist/Technologist
  • Ruston, LA
  • NPI 1376216788
  NPD Authorized official
• Melanie Massey Infant & Toddler LLC

  • Speech-Language Pathologist
  • West Monroe, LA
  • NPI 1447453865

  Physical Therapist

  NPD (past)
• Melanie Massey Physical Therapy Inc

  • Physical Therapist
  • Monroe, LA
  • NPI 1104922475
  NPD (past)

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

{
    "created_epoch": "1244505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1295961910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "683 ROACH RD",
            "city": "CHOUDRANT",
            "state": "LA",
            "postal_code": "712273630",
            "telephone_number": "318-224-9081",
            "fax_number": "318-224-9083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 EAST KENTUCKY AVE",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "71270",
            "telephone_number": "318-224-9081",
            "fax_number": "318-224-9083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-09",
        "last_updated": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "07573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1884600",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Austin Riley
• Wynne Dee Rinicker, APRN/MASTER FNP
• Rise of Ruston LLC
• Rising Kare Counseling LLC
• RL Investment Group, LLC
• David Jacob Roark
• Robert B Kirton, DPM Inc
• Robert C. Rendina, D.C., Apc
• Jesse Henton Roberts Jr., DDS
• Jesse Henton Roberts III, DDS

• Physical Therapist in Ruston, LA
• Providers in Ruston, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; 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.