Kassi Dawn McCormick, PTA
Individual provider Active NPI Physical Therapy Assistant · Wayne City, IL
NPI 1326315318 · NPPES record last updated Nov 19, 2011
Key facts
- NPI
- 1326315318
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 160.005380 (IL)
- Practice address
- Rural Route Box 270a
Wayne City, IL 62895 - Phone
- (618) 231-3019
- NPI assigned
- Nov 19, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 160.005380 | IL | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 160.005380 | IL | Yes |
Addresses
Primary practice location
Rural Route Box 270a
Wayne City, IL 62895
Mailing address
Rural Route Box 270a
Wayne City, IL 62895
Phone (618) 231-3019
Other providers in Wayne City, IL
- Tiffany Blasdel
- Crossroads Physician Corp
- Deaconess Illinois Crossroads Inc
- Lisa K Feather
- Sherry Charlette Locey
- National Healthcare of Mt Vernon Inc
- National Healthcare of Mt Vernon Inc
- Village of Wayne City
- Wayne City Community School District 100
All providers in Wayne City, IL · Physical Therapy Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.