Sidewalk Therapy Group, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SIDEWALK THERAPY GROUP, LLC

Practice address

2200 Kavanaugh Blvd
Little Rock, AR 72205-3936

Phone

(501) 251-7864

NPI assigned

Apr 17, 2023

Organization subpart

No

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

Authorized official

Name

Kelli Reyes, DPTNPI 1386835460

Title

Owner

Phone

(501) 251-7864

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelli Reyes, PT

  • Physical Therapist
  • Little Rock, AR
  • NPI 1386835460
  NPD Authorized official

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

{
    "created_epoch": "1681689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681689600000",
    "number": "1396431920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1624 N POLK ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722075328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 KAVANAUGH BLVD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053936",
            "telephone_number": "501-251-7864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIDEWALK THERAPY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-17",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-16",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "KELLI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-251-7864",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roopa S Siddaiah, M.D
• Mohammad Saif-Ur-Rehmam Siddiqui, MD
• Sayyadul M Siddiqui, MD
• Shagufta P Siddiqui, MD
• Zainab Siddiqui, MD
• Drew Siebenmorgen, PA-C
• Jacob Siebenmorgen, MD, MPH
• Brian Sieczkowski, P.T.
• Madison Siems, M.S., CF-SLP
• Martin L Siems, M.D.

• Physical Therapist in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.