Individual provider Active NPI

Kaylie West, PTA

  • Physical Therapy Assistant
  • Bismarck, ND
National Provider Identifier
1538840772
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
1294A Issued in ND
Practice address
1138 N 3Rd St
Bismarck, ND 58501-3556
Phone
(701) 258-1569
Fax
(701) 223-1669
NPI assigned
Jul 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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 1294A ND Primary

Addresses

Primary practice location

1138 N 3Rd St
Bismarck, ND 58501-3556

Mailing address

1138 N 3Rd St
Bismarck, ND 58501-3556
Phone (701) 258-1569

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
1294ANDMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Enrichment Garden CurrentSince Nov 5, 2023 Accepting new patients

Locations

1138 N 3rd St
Bismarck, ND 58501
Phone (701) 258-1569

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1538840772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1138 N 3RD ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585013556",
            "telephone_number": "701-258-1569",
            "fax_number": "701-223-1669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 N 3RD ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585013556",
            "telephone_number": "701-258-1569",
            "fax_number": "701-223-1669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEST",
        "first_name": "KAYLIE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ND",
            "license": "1294A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.