Active NPI
Kathryn Oliver
- Physical Therapy Assistant
- Rio Rancho, NM
National Provider Identifier
1306205265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A-164
- Practice address
- 4210 Sabana Grande Ave SE
Rio Rancho, NM 87124-1152 - Phone
- (505) 816-7534
- Fax
- (505) 892-6606
- NPI assigned
- Feb 19, 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 | A-164 | NM | Primary |
Addresses
Primary practice location
4210 Sabana Grande Ave SE
Rio Rancho, NM 87124-1152
Mailing address
4210 Sabana Grande Ave SE
Rio Rancho, NM 87124-1152
Phone (505) 816-7534
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 |
|---|---|---|---|
| A-164 | NM | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455840000000",
"number": "1306205265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4210 SABANA GRANDE AVE SE",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871241152",
"telephone_number": "505-816-7534",
"fax_number": "505-892-6606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4210 SABANA GRANDE AVE SE",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871241152",
"telephone_number": "505-816-7534",
"fax_number": "505-892-6606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIVER",
"first_name": "KATHRYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-19",
"last_updated": "2016-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NM",
"license": "A-164",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rio Rancho, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.