Khariza Mae C Bagacay, PT,DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

009004 Issued in KY

Practice address

3615 E John Rowan Blvd Ste 201
Bardstown, KY 40004-3265

Phone

(502) 331-4778

NPI assigned

Nov 15, 2024

Last updated

Nov 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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)

Enrolled

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

{
    "created_epoch": "1731628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1497570311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3615 E JOHN ROWAN BLVD STE 201",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400043265",
            "telephone_number": "502-331-4778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 E JOHN ROWAN BLVD STE 201",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400043265",
            "telephone_number": "502-331-4778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGACAY",
        "first_name": "KHARIZA MAE",
        "middle_name": "C",
        "credential": "PT,DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-15",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "009004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annandlee, PLLC (Bardstown Ambulatory Care)
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• Associates in General Surgery,PSC
• Astra Recovery Centers, LLC (Ascension Center for Recovery)
• Amy Auberry
• Ceceilia McAdams Baker, LCSW LMFT
• Angela Marie Ballard
• Cindy Ballard, LCADC
• Elise Nicole Ballard, MHA
• Baptist Health Medical Group Inc

• Physical Therapist in Bardstown, KY
• Providers in Bardstown, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; 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.