Active NPI
Tabitha C Price, PTA
- Physical Therapy Assistant
- Peoria, IL
National Provider Identifier
1427885086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 160.010238
- Practice address
- 117 N Western Ave
Peoria, IL 61604-5650 - Phone
- (309) 674-2400
- NPI assigned
- Sep 17, 2024
- Last updated
- Sep 17, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 160.010238 | IL | Primary |
Addresses
Primary practice location
117 N Western Ave
Peoria, IL 61604-5650
Mailing address
3804 S Granville Ave
Bartonville, IL 61607-2244
Phone (309) 258-2883
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
| License | State | Type | Specialty |
|---|---|---|---|
| 160.010238 | IL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726531200000",
"number": "1427885086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3804 S GRANVILLE AVE",
"city": "BARTONVILLE",
"state": "IL",
"postal_code": "616072244",
"telephone_number": "309-258-2883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 N WESTERN AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616045650",
"telephone_number": "309-674-2400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRICE",
"first_name": "TABITHA",
"middle_name": "C",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-17",
"last_updated": "2024-09-17",
"certification_date": "2024-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IL",
"license": "160.010238",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.