Active NPI
Nickia R Vance, PTA
- Physical Therapy Assistant
- Belleville, KS
National Provider Identifier
1447429006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 10400900
- Practice address
- 2626 Wesleyan Dr
Belleville, KS 66935-2440 - Phone
- (785) 527-5636
- NPI assigned
- Feb 27, 2008
- 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 | 10400900 | KS | Primary |
Addresses
Primary practice location
2626 Wesleyan Dr
Belleville, KS 66935-2440
Mailing address
2222 Sullivan TRL
Easton, PA 18040-7958
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 |
|---|---|---|---|
| 10400900 | KS | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204070400000",
"number": "1447429006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2222 SULLIVAN TRL",
"city": "EASTON",
"state": "PA",
"postal_code": "180407958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2626 WESLEYAN DR",
"city": "BELLEVILLE",
"state": "KS",
"postal_code": "669352440",
"telephone_number": "785-527-5636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANCE",
"first_name": "NICKIA",
"middle_name": "R",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-27",
"last_updated": "2008-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "KS",
"license": "10400900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belleville, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.