Individual provider Active NPI

Kimberly Dyan Cortez, LPTA

  • Physical Therapy Assistant
  • Oregon, OH
National Provider Identifier
1457558033
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA01870 Issued in OH
Practice address
904 Isaac Streets Dr
Oregon, OH 43616-3204
Phone
(419) 691-2483
Fax
(419) 693-4162
NPI assigned
Jun 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA01870 OH Primary

Addresses

Primary practice location

904 Isaac Streets Dr
Oregon, OH 43616-3204

Mailing address

1040 Schmidlin Rd
Oregon, OH 43616-3406
Phone (419) 691-6897

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
PTA01870OHMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457558033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 SCHMIDLIN RD",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436163406",
            "telephone_number": "419-691-6897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 ISAAC STREETS DR",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436163204",
            "telephone_number": "419-691-2483",
            "fax_number": "419-693-4162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORTEZ",
        "first_name": "KIMBERLY",
        "middle_name": "DYAN",
        "name_prefix": "Mrs.",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "PTA01870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.