Kathleen Marie Carico, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2005020699 Issued in MO

Practice address

1125 Madison St
Jefferson City, MO 65101-5227

Phone

(573) 632-5621

NPI assigned

May 30, 2007

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508067067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 OLD GIBLER RD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651091117",
            "telephone_number": "573-893-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 MADISON ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651015227",
            "telephone_number": "573-632-5621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARICO",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2005020699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Physical Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.