Active NPI
Tammy Lynn Hacker, PTA
- Physical Therapy Assistant
- Manchester, KY
National Provider Identifier
1326371287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A02401
- Practice address
- 210 Marie Langdon Dr
Manchester, KY 40962-6388 - Phone
- (606) 598-4506
- Fax
- (606) 598-1027
- NPI assigned
- Sep 10, 2009
- 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 | A02401 | KY | Primary |
Addresses
Primary practice location
210 Marie Langdon Dr
Manchester, KY 40962-6388
Mailing address
P.O. Box 357
134 Jasmine Lane
Stinnet, KY 40868
Phone (606) 598-4506
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01004431 | Medicaid | KY |
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 |
|---|---|---|---|
| A02401 | KY | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252540800000",
"number": "1326371287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 357",
"address_2": "134 JASMINE LANE",
"city": "STINNET",
"state": "KY",
"postal_code": "40868",
"telephone_number": "606-598-4506",
"fax_number": "606-598-1027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 MARIE LANGDON DR",
"city": "MANCHESTER",
"state": "KY",
"postal_code": "409626388",
"telephone_number": "606-598-4506",
"fax_number": "606-598-1027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HACKER",
"first_name": "TAMMY",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-10",
"last_updated": "2009-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "KY",
"license": "A02401",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01004431",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manchester, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.