Kaleb Drake, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT5414 Issued in AR

Practice address

10825 Financial Centre Pkwy Ste 210
Little Rock, AR 72211-3545

Phone

(501) 223-8310

NPI assigned

Oct 8, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1633651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1316609159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 WALNUT ST STE 110",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012416",
            "telephone_number": "805-788-0805",
            "fax_number": "805-788-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10825 FINANCIAL CENTRE PKWY STE 210",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113545",
            "telephone_number": "501-223-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "KALEB",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-08",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT5414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.