Kerri Amber Davidson, P.T.A.

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

001200 Issued in IA

Practice address

315 W 5TH St
Storm Lake, IA 50588-1743

Phone

(712) 732-7725

Fax

(712) 732-1275

NPI assigned

Aug 22, 2007

Sex

Female

Sole proprietor

No

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)

Not enrolled

State licenses

Practice roles

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.

• Sports Rehab & Professional Therapy Associates

  • Customized Equipment (DME)
  • Storm Lake, IA
  • NPI 1285772970
  NPD (past)
• Sports Rehab and Professional Therapy Associates Inc

  • Rehabilitation Clinic/Center
  • Storm Lake, IA
  • NPI 1033289749

  Physical Therapy Assistant

  NPD (past)

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187740800000",
    "number": "1326231317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W 5TH ST",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "505881743",
            "telephone_number": "712-732-7725",
            "fax_number": "712-732-1275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W 5TH ST",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "505881743",
            "telephone_number": "712-732-7725",
            "fax_number": "712-732-1275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "KERRI",
        "middle_name": "AMBER",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2007-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IA",
            "license": "001200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0665141",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Crippin, MD
• Craig D Crouch, O.D.
• Donovan Lee Crouch, O.D.
• Timothy Daniels, MD
• Allyson Marie Davidson, DPT
• Faith E Daws, PHYSICAL THERAPIST
• Fred Dehaan, O.D.
• Michael A Dehner, MD
• Larry Joseph Dellwo, M.A.
• Jason Michael Dierking, M.D.

• Physical Therapy Assistant in Storm Lake, IA
• Providers in Storm Lake, IA by specialty
• Physical Therapy Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; 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.