Kateasta Nicole Malloy, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

001265 Issued in WV

Practice address

95 Colonial Heights Dr
Fort Ashby, WV 26719-6962

Phone

(301) 876-8087

NPI assigned

Oct 29, 2024

Last updated

Oct 29, 2024By 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

Other names 1

• Kateasta Nicole Malloy Professional name

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": "1730160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1669294948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 COLONIAL HEIGHTS DR",
            "city": "FORT ASHBY",
            "state": "WV",
            "postal_code": "267196962",
            "telephone_number": "301-876-8087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 COLONIAL HEIGHTS DR",
            "city": "FORT ASHBY",
            "state": "WV",
            "postal_code": "267196962",
            "telephone_number": "301-876-8087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLOY",
        "first_name": "KATEASTA",
        "middle_name": "NICOLE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-29",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WV",
            "license": "001265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATEASTA",
            "last_name": "MALLOY",
            "middle_name": "NICOLE",
            "credential": "PTA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Elizabeth Renee Lynn Kinsall
• Miranda Kott
• Kelsey Lapp
• Raymond Lolli
• Teresa Louise Lucas
• Alyssa McGuire
• Krystal Nicole Mullins
• Tilder Kumichii Ndichia, RESPITE WORKER
• Cathy Ann Nester, HIS
• Melvin Keith Nester Sr., BC-HIS

• Physical Therapy Assistant in Fort Ashby, WV
• Providers in Fort Ashby, WV by specialty
• Physical Therapy Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.