Mattie Mae Feldkamp, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1403464 Issued in KS

Practice address

608 N Mulberry Rd
Derby, KS 67037-3532

Phone

(316) 202-0996

Fax

(316) 202-0997

NPI assigned

Dec 11, 2018

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

• Mattie Mae Milligan Former name

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": "1544486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571961600000",
    "number": "1417428863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W DOUGLAS AVE STE 1040",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672023017",
            "telephone_number": "316-263-0003",
            "fax_number": "316-263-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 N MULBERRY RD",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670373532",
            "telephone_number": "316-202-0996",
            "fax_number": "316-202-0997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELDKAMP",
        "first_name": "MATTIE MAE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-11",
        "last_updated": "2019-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "KS",
            "license": "1403464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MATTIE MAE",
            "last_name": "MILLIGAN",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapy Assistant in Derby, KS
• Providers in Derby, KS by specialty
• Physical Therapy Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2019; 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.