Kyle Thomas Williams, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

40QB00342200 Issued in NJ

Practice address

1155 Pleasant Valley Way
West Orange, NJ 07052-1498

Phone

(973) 731-5100

NPI assigned

Nov 1, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1541030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541030400000",
    "number": "1487121992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 LINCOLN ST",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424429",
            "telephone_number": "973-393-6781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 PLEASANT VALLEY WAY",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521498",
            "telephone_number": "973-731-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KYLE",
        "middle_name": "THOMAS",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-01",
        "last_updated": "2018-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NJ",
            "license": "40QB00342200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derek Widmayer, DMD
• Brittany Wilkerson-Galvin, LAC
• Jami Wilkinson
• William Nadelberg Etal PTR William Nadelberg
• J Bradley Williams, PHD
• Lyndsey Rose Williams, PTA
• Todd E Williams, DPT
• Esther Lily Williamson, DPT
• Cecilia Wilson
• James R Wilson, DO

• Physical Therapy Assistant in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Physical Therapy Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2018; 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.