Active NPI
Kala Brown Kegarise, PT
- Physical Therapist
- Gladewater, TX
National Provider Identifier
1699276113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1370898
- Practice address
- 700B E Lake Dr
Gladewater, TX 75647-5101 - Phone
- (903) 736-8328
- NPI assigned
- Feb 21, 2018
- Last updated
- Jan 17, 2023
- Sex
- Female
- Sole proprietor
- No
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 Therapist | 225100000X | 1370898 | TX | Primary |
Addresses
Primary practice location
700B E Lake Dr
Gladewater, TX 75647-5101
Mailing address
700B E Lake Dr
Gladewater, TX 75647-5101
Phone (903) 736-8328
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 |
|---|---|---|---|
| 1370898 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673913600000",
"number": "1699276113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700B E LAKE DR",
"city": "GLADEWATER",
"state": "TX",
"postal_code": "756475101",
"telephone_number": "903-736-8328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700B E LAKE DR",
"city": "GLADEWATER",
"state": "TX",
"postal_code": "756475101",
"telephone_number": "903-736-8328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEGARISE",
"first_name": "KALA",
"middle_name": "BROWN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-21",
"last_updated": "2023-01-17",
"certification_date": "2023-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1370898",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gladewater, TX
- Gregory Stephen Jeffers, MS, LAT, PES, CES
- Lynn Karin Jennings, M.D.
- Irene Elizabeth Johnson
- Joken Inc (Jobe Drug Co)
- Kcam Consulting
- L-M-R Health Care Services Inc
- Iesha Michelle Lane, SLP
- Edward Chestley Ledbetter, DC
- Legend Healthcare Gladewater, LP (Legend Oaks Healthcare and Rehab Ctr - Gladewater)
- Longview Walk-in Clinic
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.