Active NPI
Keosha Lashell Houston, PTA
- Physical Therapy Assistant
- Fayetteville, NC
National Provider Identifier
1316438252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A4470
- Practice address
- 424 McArthur Rd
Fayetteville, NC 28311-6924 - Phone
- (910) 868-2002
- Fax
- (910) 868-2004
- NPI assigned
- May 26, 2018
- 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 | A4470 | NC | Primary |
Addresses
Primary practice location
424 McArthur Rd
Fayetteville, NC 28311-6924
Mailing address
2757 Mewborn Church Rd
Snow Hill, NC 28580-8973
Phone (615) 426-6174
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 |
|---|---|---|---|
| A4470 | NC | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RDL Therapeutic Outpatient Therapy | Physical Therapy Assistant | Past | Accepting new patients |
| Sozo Family Care Home Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Adult Care Home Facility
- Snow Hill, NC
- NPI 1376815365
-
- Physical Therapist
- Fayetteville, NC
- NPI 1275030272
Physical Therapy Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527292800000",
"number": "1316438252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2757 MEWBORN CHURCH RD",
"city": "SNOW HILL",
"state": "NC",
"postal_code": "285808973",
"telephone_number": "615-426-6174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "424 MCARTHUR RD",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283116924",
"telephone_number": "910-868-2002",
"fax_number": "910-868-2004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOUSTON",
"first_name": "KEOSHA",
"middle_name": "LASHELL",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-26",
"last_updated": "2018-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NC",
"license": "A4470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.