Keena Natashia Edwards, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA6225 Issued in AL

Practice address

5009 River Chase Dr
Ste 100C
Phenix City, AL 36867-7484

Phone

(334) 298-0650

Fax

(334) 298-1020

NPI assigned

May 18, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1337299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527724800000",
    "number": "1598025074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212564",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5009 RIVER CHASE DR",
            "address_2": "STE 100C",
            "city": "PHENIX CITY",
            "state": "AL",
            "postal_code": "368677484",
            "telephone_number": "334-298-0650",
            "fax_number": "334-298-1020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2450 Village Professional Dr N",
            "address_purpose": "LOCATION",
            "city": "Opelika",
            "state": "AL",
            "postal_code": "368014734",
            "country_code": "US",
            "telephone_number": "334-528-1964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "KEENA",
        "middle_name": "NATASHIA",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-18",
        "last_updated": "2018-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AL",
            "license": "PTA6225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EAST ALABAMA MEDICAL CENTER",
            "identifier": "636000526",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Creighton Elias, LPC
• Christensen Andal Elizaga

• Physical Therapy Assistant in Phenix City, AL
• Providers in Phenix City, AL by specialty
• Physical Therapy Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; 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.