Blythe Kolb, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA27229 Issued in FL

Practice address

3005 S Congress Ave
Boynton Beach, FL 33426-9045

Phone

(772) 342-3834

NPI assigned

Jun 8, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Blythe Dewall Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Palm Beach Physical Therapy Group, LLC

  • Physical Therapist
  • Boynton Beach, FL
  • NPI 1639764962
  NPD

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1366019259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1981 SW AARON LN",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349532127",
            "telephone_number": "772-342-3834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 S CONGRESS AVE",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334269045",
            "telephone_number": "772-342-3834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLB",
        "first_name": "BLYTHE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA27229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BLYTHE",
            "last_name": "DEWALL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Knucks Labs LLC
• Cheryl Ann Koch, PT
• Gary S Kodish, DDS
• Gary Gilbert Koesten, R.PH.
• Francyne Lynn Kohler, DDS
• Gila Kolodny, MHC, LSP
• Yitzchok Kolodny, PT
• Kathryn E Kolovani-Tumminia, DMD
• Julie Konowitz Sirkin, MD
• Michael J Konzela, DDS

• Physical Therapy Assistant in Boynton Beach, FL
• Providers in Boynton Beach, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.