Individual provider Active NPI

Holly Lane Knowles, PTA

  • Physical Therapy Assistant
  • Ramrod Key, FL
National Provider Identifier
1497090401
Registry record updated Dec 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA 22614 Issued in FL
Practice address
371 Coral Ave
Ramrod Key, FL 33042-5323
Phone
(850) 419-4191
NPI assigned
Dec 2, 2012
Last updated
Dec 2, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2012

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 PTA 22614 FL Primary

Addresses

Primary practice location

371 Coral Ave
Ramrod Key, FL 33042-5323

Mailing address

371 Coral Ave
Ramrod Key, FL 33042-5323
Phone (850) 419-4191

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
PTA 22614FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1354406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354406400000",
    "number": "1497090401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 CORAL AVE",
            "city": "RAMROD KEY",
            "state": "FL",
            "postal_code": "330425323",
            "telephone_number": "850-419-4191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 CORAL AVE",
            "city": "RAMROD KEY",
            "state": "FL",
            "postal_code": "330425323",
            "telephone_number": "850-419-4191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOWLES",
        "first_name": "HOLLY",
        "middle_name": "LANE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-02",
        "last_updated": "2012-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA 22614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ramrod Key, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2012; 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.