Individual provider Active NPI

Kara Stephens

  • Physical Therapy Assistant
  • Fort Wayne, IN
National Provider Identifier
1417526849
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
06006204A Issued in IN
Practice address
9436 Arundel Run
Fort Wayne, IN 46835-9115
Phone
(260) 492-3730
NPI assigned
Jun 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 225200000X 06006204A IN Primary

Addresses

Primary practice location

9436 Arundel Run
Fort Wayne, IN 46835-9115

Mailing address

9436 Arundel Run
Fort Wayne, IN 46835-9115

Other identifiers 1

IdentifierTypeStateIssuer
BGI812306494OtherBLUE CROSS BLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL k-stephens@onu.edu

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

LicenseStateTypeSpecialty
06006204AINMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1417526849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9436 ARUNDEL RUN",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468359115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9436 ARUNDEL RUN",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468359115",
            "telephone_number": "260-492-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "KARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-21",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06006204A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "BGI812306494",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "k-stephens@onu.edu",
            "affiliation": "N",
            "address_1": "9436 Arundel Run",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468359115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.