Kim Utley, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2096525 Issued in TX

Practice address

719 W Coke Rd
Winnsboro, TX 75494-3011

Phone

(903) 342-3987

NPI assigned

Nov 7, 2019

Last updated

Nov 7, 2019By 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)

Not enrolled

State licenses

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

{
    "created_epoch": "1573084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1598300147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 PRIVATE ROAD 7952",
            "city": "MINEOLA",
            "state": "TX",
            "postal_code": "757735231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 W COKE RD",
            "city": "WINNSBORO",
            "state": "TX",
            "postal_code": "754943011",
            "telephone_number": "903-342-3987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTLEY",
        "first_name": "KIM",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-07",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2096525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shane Tilbury
• Titus County Hospital District (Avir at Winnsboro)
• Rhonda Tower Siddens, FNP, PHD
• Trinity Mission of Winnsboro, LLC (Trinity Mission Health & Rehab of Winnsboro)
• Trinity Nursing and Rehabilitation of Winnsboro, LP
• Virginia L Davis (Star CPD Services)
• Beverly G Walker
• West Wharton County Hospital District (Lakeview Rehabilitation and Healthcare Center)
• Whispering Pines a Texas General Partnership
• Whispering Pines Nursing and Rehabilitation, LP

• Physical Therapy Assistant in Winnsboro, TX
• Providers in Winnsboro, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; 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.