Active NPI
Karen Villani Nye, PT
- Pediatric Physical Therapist
- Tyrone, GA
National Provider Identifier
1467683268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 004893
- Practice address
- 105 Glendalough CT
Suite H
Tyrone, GA 30290-2948 - Phone
- (678) 632-6765
- Fax
- (678) 550-7931
- NPI assigned
- Jul 28, 2009
- Last updated
- Jun 28, 2013
- 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 004893 | GA | Primary |
Addresses
Primary practice location
105 Glendalough CT
Suite H
Tyrone, GA 30290-2948
Mailing address
1029 N Peachtree Pkwy
Box 156
Peachtree City, GA 30269-4210
Phone (678) 632-6765
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 |
|---|---|---|---|
| 004893 | GA | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372377600000",
"number": "1467683268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1029 N PEACHTREE PKWY",
"address_2": "BOX 156",
"city": "PEACHTREE CITY",
"state": "GA",
"postal_code": "302694210",
"telephone_number": "678-632-6765",
"fax_number": "678-550-7931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 GLENDALOUGH CT",
"address_2": "SUITE H",
"city": "TYRONE",
"state": "GA",
"postal_code": "302902948",
"telephone_number": "678-632-6765",
"fax_number": "678-550-7931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NYE",
"first_name": "KAREN",
"middle_name": "VILLANI",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-28",
"last_updated": "2013-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "GA",
"license": "004893",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tyrone, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.