Kimberly L Gallagher, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA2023 Issued in AR

Practice address

1501 SE Walton Blvd Ste 109
Bentonville, AR 72712-3745

Phone

(479) 273-2345

NPI assigned

Feb 28, 2008

Last updated

Feb 28, 2008By 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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Northwest Arkansas Pediatric Therapy Services, Inc

  • Pediatric Physical Therapist
  • Pea Ridge, AR
  • NPI 1447472865
  NPD (past)

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204156800000",
    "number": "1689843112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 585",
            "city": "PEA RIDGE",
            "state": "AR",
            "postal_code": "727510585",
            "telephone_number": "479-273-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 SE WALTON BLVD STE 109",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123745",
            "telephone_number": "479-273-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "KIMBERLY",
        "middle_name": "L",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-28",
        "last_updated": "2008-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "PTA2023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTA LICENSE",
            "identifier": "PTA2023",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fusion Therapy Center, LLC
• Julianne Futrell
• Rachel J Gabbard, PLMSW
• Alysson Blythe Gaines
• Bethany Anne Galimore, D.C.
• Morgan Ganoung
• Helena Garcia, MHPP
• Jennfer Lynn Garcia, BS OF PHARMACY, RPH
• Nicole Garix
• James Garland, PHARMD

• Physical Therapy Assistant in Bentonville, AR
• Providers in Bentonville, 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 Feb 28, 2008; 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.