Active NPI
Kaylee Glenn Nelson Sparks
- Physical Therapy Assistant
- Moulton, AL
National Provider Identifier
1356128151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA11083
- Practice address
- 300 Hospital St
Moulton, AL 35650-1268 - Phone
- (256) 974-1146
- NPI assigned
- Sep 13, 2023
- 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 | PTA11083 | AL | Primary |
Addresses
Primary practice location
300 Hospital St
Moulton, AL 35650-1268
Mailing address
300 Hospital St
Moulton, AL 35650-1268
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 |
|---|---|---|---|
| PTA11083 | AL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694563200000",
"number": "1356128151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 HOSPITAL ST",
"city": "MOULTON",
"state": "AL",
"postal_code": "356501268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 HOSPITAL ST",
"city": "MOULTON",
"state": "AL",
"postal_code": "356501268",
"telephone_number": "256-974-1146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPARKS",
"first_name": "KAYLEE",
"middle_name": "GLENN NELSON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-13",
"last_updated": "2023-09-13",
"certification_date": "2023-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AL",
"license": "PTA11083",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moulton, AL
- Jennifer Lee Smith, PTA
- Linda Hammons Smith, COTA/L
- Tabetha W Smith
- Terri Smith, BS
- Southern Hospitality Home & Health Care, Inc.
- Delanie Compton Standridge, M.S. CCC-SLP
- State of Alabama
- State of Alabama Department of Public Health
- State of Alabama Department of Public Health
- State of Alabama Department of Public Health
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.