Kristen Souder, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

005562 Issued in OH

Practice address

2003 Veterans Blvd
Georgetown, OH 45121-7408

Phone

(937) 515-0997

NPI assigned

Oct 14, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1539475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539475200000",
    "number": "1417423740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 EBRITE RD",
            "city": "WEST UNION",
            "state": "OH",
            "postal_code": "456939709",
            "telephone_number": "937-515-0997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 VETERANS BLVD",
            "city": "GEORGETOWN",
            "state": "OH",
            "postal_code": "451217408",
            "telephone_number": "937-515-0997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUDER",
        "first_name": "KRISTEN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-14",
        "last_updated": "2018-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "005562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Grace Smith
• Lisa Smith, LCDCII
• Donald Snider
• Elizabeth Snodgrass
• Emily Souder, MED, LPCC-S, NCC
• Southwest Healthcare of Brown County Ohio, LLC
• Southwest Ohio Anesthesia Inc
• Southwest Regional Home Care Inc.
• Tracy Spires, ED.S, NCSP
• State of Ohio Office of Budget and Management State Accounting

• Physical Therapy Assistant in Georgetown, OH
• Providers in Georgetown, OH by specialty
• Physical Therapy Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2018; 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.