Active NPI
Kevin Jay King, PTA
- Physical Therapy Assistant
- Oviedo, FL
National Provider Identifier
1659581171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA18368
- Practice address
- 1525 Haven Dr
Oviedo, FL 32765-7566 - Phone
- (407) 706-1270
- Fax
- (407) 706-1271
- NPI assigned
- May 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | PTA18368 | FL | Primary |
Addresses
Primary practice location
1525 Haven Dr
Oviedo, FL 32765-7566
Mailing address
1426 Moorland CT
Longwood, FL 32750-3311
Phone (407) 774-1610
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 |
|---|---|---|---|
| PTA18368 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659581171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1426 MOORLAND CT",
"city": "LONGWOOD",
"state": "FL",
"postal_code": "327503311",
"telephone_number": "407-774-1610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1525 HAVEN DR",
"city": "OVIEDO",
"state": "FL",
"postal_code": "327657566",
"telephone_number": "407-706-1270",
"fax_number": "407-706-1271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "KEVIN",
"middle_name": "JAY",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "PTA18368",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oviedo, FL
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.