Active NPI
Christy Lynn Douglas, PTA
- Physical Therapy Assistant
- Corning, IA
National Provider Identifier
1598889073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 00634
- Practice address
- 603 Rosary Dr
Corning, IA 50841-1683 - Phone
- (641) 333-6249
- NPI assigned
- Mar 19, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 00634 | IA | Primary |
Addresses
Primary practice location
603 Rosary Dr
Corning, IA 50841-1683
Mailing address
1209 Quail Ave
Lenox, IA 50851-8106
Phone (641) 333-2569
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
| License | State | Type | Specialty |
|---|---|---|---|
| 00634 | IA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598889073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1209 QUAIL AVE",
"city": "LENOX",
"state": "IA",
"postal_code": "508518106",
"telephone_number": "641-333-2569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "603 ROSARY DR",
"city": "CORNING",
"state": "IA",
"postal_code": "508411683",
"telephone_number": "641-333-6249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLAS",
"first_name": "CHRISTY",
"middle_name": "LYNN",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IA",
"license": "00634",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corning, IA
- Corning C.S.D.
- Corning Community School
- Corning Family Chiropractic, P.C.
- Paislee R Dalton, NP
- Jennifer Saar Delavan, PT, DPT
- Dr. Robert H. Sharp, P.C. (DBA Family Vision Center)
- Eye Care Associates of Co, LLC (Family Vision Center - Corning)
- Steven Allen Freeman, MD
- Fuller Family Dental, PLC
- Greater Regional Medical Center (Corning Medical Clinic)
Sources for this page
- 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.