Banessa Calderon, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

4830 Issued in AR

Practice address

1821 Phoenix Ave Ste a
Fort Smith, AR 72901-7939

Phone

(501) 772-1461

NPI assigned

Jun 5, 2023

Last updated

Jun 5, 2023By 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

Practice roles

Locations

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

• Sprouts Therapy Center

  • Physical Therapist
  • Fort Smith, AR
  • NPI 1154059251
  NPD

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1619661444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 PHOENIX AVE STE A",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729017939",
            "telephone_number": "501-772-1461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 PHOENIX AVE STE A",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729017939",
            "telephone_number": "501-772-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDERON",
        "first_name": "BANESSA",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "4830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuell Leyton Cabe, PT, DPT
• Jamie L Cagle, APRN
• Martin Wesley Cain, MD
• Tracita Joanne Caldarera, OTR/L
• Alex Eduardo Calderon Rodriguez, M.D.
• Annelle Rae Caldwell, PTA
• Rebecca L Calhoun, QBHP
• Michael W Callaway, MD
• Chealsea Calloway
• Calming Voice Counseling Services LLC

• Physical Therapy Assistant in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Physical Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.