Active NPI
Kayla Gibbons
- Physical Therapy Assistant
- Juneau, WI
National Provider Identifier
1346868296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2483-19
- Practice address
- 198 County Road DF
Juneau, WI 53039-9515 - Phone
- (920) 386-3548
- NPI assigned
- Jul 8, 2020
- Last updated
- Jul 8, 2020
- 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 | 2483-19 | WI | Primary |
Addresses
Primary practice location
198 County Road DF
Juneau, WI 53039-9515
Mailing address
106 S Holmen Dr Ste 2
Holmen, WI 54636-9468
Phone (608) 526-9888
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 |
|---|---|---|---|
| 2483-19 | WI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594166400000",
"number": "1346868296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 S HOLMEN DR STE 2",
"city": "HOLMEN",
"state": "WI",
"postal_code": "546369468",
"telephone_number": "608-526-9888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "198 COUNTY ROAD DF",
"city": "JUNEAU",
"state": "WI",
"postal_code": "530399515",
"telephone_number": "920-386-3548"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBONS",
"first_name": "KAYLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-08",
"last_updated": "2020-07-08",
"certification_date": "2020-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "2483-19",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Juneau, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.