NPIMap

Individual provider Active NPI

Karen M. Small, P.T.A.

  • Physical Therapy Assistant
  • Cleveland, OH
National Provider Identifier
1497199822
Registry record updated Apr 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA04853 Issued in OH
Practice address
6500 Rockside Rd, Suite 240
Supplemental Health Care
Cleveland, OH 44131
Phone
(216) 901-0400
Fax
(216) 901-0401
NPI assigned
Apr 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA04853 OH Primary
Massage Therapist 225700000X LMT OH

Addresses

Primary practice location

6500 Rockside Rd, Suite 240
Supplemental Health Care
Cleveland, OH 44131

Mailing address

6500 Rockside Rd, Suite 240
Supplemental Health Care
Cleveland, OH 44131
Phone (216) 901-0400

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
PTA04853OHMDPhysical Therapy Assistant
LMTOHMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367193600000",
    "number": "1497199822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 ROCKSIDE RD, SUITE 240",
            "address_2": "SUPPLEMENTAL HEALTH CARE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44131",
            "telephone_number": "216-901-0400",
            "fax_number": "216-901-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 ROCKSIDE RD, SUITE 240",
            "address_2": "SUPPLEMENTAL HEALTH CARE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44131",
            "telephone_number": "216-901-0400",
            "fax_number": "216-901-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "KAREN",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-29",
        "last_updated": "2013-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "PTA04853",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OH",
            "license": "LMT",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.

Verify at the official NPI Registry.