Individual provider Active NPI

Candy Rebonna Tawbush, PTA

  • Physical Therapist
  • Bessemer, AL
National Provider Identifier
1336245117
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTA3888 Issued in AL
Practice address
718 Academy Dr
Ste 100
Bessemer, AL 35022-3305
Phone
(205) 428-7774
Fax
(205) 428-6928
NPI assigned
Sep 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTA3888 AL Primary

Addresses

Primary practice location

718 Academy Dr
Ste 100
Bessemer, AL 35022-3305

Mailing address

455 Wildland TRL
Cordova, AL 35550-3759
Phone (205) 648-2820

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
PTA3888ALMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physiotherapy Associates Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336245117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 WILDLAND TRL",
            "city": "CORDOVA",
            "state": "AL",
            "postal_code": "355503759",
            "telephone_number": "205-648-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 ACADEMY DR",
            "address_2": "STE 100",
            "city": "BESSEMER",
            "state": "AL",
            "postal_code": "350223305",
            "telephone_number": "205-428-7774",
            "fax_number": "205-428-6928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAWBUSH",
        "first_name": "CANDY",
        "middle_name": "REBONNA",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTA3888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bessemer, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.