Active NPI
Justin Wayne Kyser, PTA
- Physical Therapy Assistant
- Gadsden, AL
National Provider Identifier
1487254082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA9612
- Practice address
- 2301 Rainbow Dr
Gadsden, AL 35901-5517 - Phone
- (256) 543-3467
- NPI assigned
- Nov 1, 2020
- Last updated
- Nov 1, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | PTA9612 | AL | Primary |
Addresses
Primary practice location
2301 Rainbow Dr
Gadsden, AL 35901-5517
Mailing address
325 Coal St
Sandrock, AL 35983-4385
Phone (256) 844-0723
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 |
|---|---|---|---|
| PTA9612 | AL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604188800000",
"number": "1487254082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 COAL ST",
"city": "SANDROCK",
"state": "AL",
"postal_code": "359834385",
"telephone_number": "256-844-0723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 RAINBOW DR",
"city": "GADSDEN",
"state": "AL",
"postal_code": "359015517",
"telephone_number": "256-543-3467"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KYSER",
"first_name": "JUSTIN",
"middle_name": "WAYNE",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-01",
"last_updated": "2020-11-01",
"certification_date": "2020-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AL",
"license": "PTA9612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gadsden, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.