Individual provider Active NPI

Kimberly Moorehead, PTA

  • Physical Therapy Assistant
  • Murfreesboro, TN
National Provider Identifier
1346080488
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
6089 Issued in TN
Practice address
1927 Memorial Blvd
Murfreesboro, TN 37129-1545
Phone
(615) 904-2449
NPI assigned
May 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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 6089 TN Primary

Addresses

Primary practice location

1927 Memorial Blvd
Murfreesboro, TN 37129-1545

Mailing address

1927 Memorial Blvd
Murfreesboro, TN 37129-1545
Phone (615) 904-2449

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
6089TNMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1346080488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1927 MEMORIAL BLVD",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371291545",
            "telephone_number": "615-904-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1927 MEMORIAL BLVD",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371291545",
            "telephone_number": "615-904-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOREHEAD",
        "first_name": "KIMBERLY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-28",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "6089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.