Individual provider Active NPI

Kelly Lynn Feiz, PTA

  • Physical Therapy Assistant
  • Worcester, MA
National Provider Identifier
1326204074
Registry record updated Aug 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
8093 Issued in MA
Practice address
484 Main St
Worcester, MA 01608-1893
Phone
(508) 751-6309
NPI assigned
Aug 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 8093 MA Primary

Addresses

Primary practice location

484 Main St
Worcester, MA 01608-1893

Mailing address

484 Main Street
Worcester, MA 01608
Phone (508) 751-6308

Other identifiers 1

IdentifierTypeStateIssuer
8093OtherMAPTA

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
8093MAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1217548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217548800000",
    "number": "1326204074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 MAIN STREET",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01608",
            "telephone_number": "508-751-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 MAIN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081893",
            "telephone_number": "508-751-6309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEIZ",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-01",
        "last_updated": "2008-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MA",
            "license": "8093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTA",
            "identifier": "8093",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.