Individual provider Active NPI

Caitlyn Rose Dymond, PTA

  • Physical Therapy Assistant
  • Kingston, PA
National Provider Identifier
1346946449
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
TEI004296 Issued in PA
Practice address
840 W Market St
Kingston, PA 18704-3337
Phone
(570) 714-0933
Fax
(570) 714-0934
NPI assigned
Feb 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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 TEI004296 PA Primary

Addresses

Primary practice location

840 W Market St
Kingston, PA 18704-3337

Mailing address

33 N Main St Ste 100
Pittston, PA 18640-1949
Phone (570) 208-2787

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
TEI004296PAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
FCC Enterprises LLC CurrentSince Oct 31, 2023 Accepting new patients
Progress Physical Therapy LLC PastSince Feb 8, 2023 Accepting new patients

Locations

840 W Market St
Kingston, PA 18704
Phone (570) 714-0933

33 N Main St
Ste 100
Pittston, PA 18640
Phone (570) 208-2787

Organizations & group practices 2

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": "1675209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1346946449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 N MAIN ST STE 100",
            "city": "PITTSTON",
            "state": "PA",
            "postal_code": "186401949",
            "telephone_number": "570-208-2787",
            "fax_number": "570-287-2788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 W MARKET ST",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187043337",
            "telephone_number": "570-714-0933",
            "fax_number": "570-714-0934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYMOND",
        "first_name": "CAITLYN",
        "middle_name": "ROSE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-01",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TEI004296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.