Kaitlyn Bullock, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A03188 Issued in KY

Practice address

485 Memorial Dr Ste 2
Manchester, KY 40962-9111

Phone

(606) 599-1709

NPI assigned

Feb 1, 2019

Last updated

Feb 1, 2019By the provider in NPPES

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

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": "1548979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548979200000",
    "number": "1649735853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 HOOKER RD",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409628132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 MEMORIAL DR STE 2",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409629111",
            "telephone_number": "606-599-1709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "KAITLYN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-01",
        "last_updated": "2019-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "KY",
            "license": "A03188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Wayne Bowling, APRN
• Christina Michelle Brandenburg
• Michael Todd Brashear, CRNA
• Erica Bright
• Terry L. Bryant, DMD
• Sarah M Burchell, PHARMD
• Case Management of Southeastern Ky
• Jacob Charles Cheek, PTA
• Karen J Cheek, A.P.R.N.
• Christian Cardiology Internal Medicine

• Physical Therapy Assistant in Manchester, KY
• Providers in Manchester, KY by specialty
• Physical Therapy Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.