Individual provider Active NPI

Vicki D Lynn, PTA

  • Physical Therapy Assistant
  • Marion, KY
National Provider Identifier
1700046794
Registry record updated Jan 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A02411 Issued in KY
Practice address
202 Tanglewood Dr
Marion, KY 42064-1913
Phone
(270) 969-0442
NPI assigned
Jun 12, 2008
Last updated
Jan 21, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A02411 KY Primary
Physical Therapy Assistant 225200000X 9688 CA
Physical Therapy Assistant 225200000X TEI002441 PA
Physical Therapy Assistant 225200000X 2079983 TX
Physical Therapy Assistant 225200000X 2403 SC
Physical Therapy Assistant 225200000X 2306602498 VA
Physical Therapy Assistant 225200000X 000001 DC
Physical Therapy Assistant 225200000X A3353 MD
Physical Therapy Assistant 225200000X 005420 IL
Physical Therapy Assistant 225200000X 21997 FL

Addresses

Primary practice location

202 Tanglewood Dr
Marion, KY 42064-1913

Mailing address

202 Tanglewood Dr
Marion, KY 42064-1913
Phone (270) 969-0442

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

LicenseStateTypeSpecialty
9688CAMDPhysical Therapy Assistant
000001DCMDPhysical Therapy Assistant
005420ILMDPhysical Therapy Assistant
A02411KYMDPhysical Therapy Assistant
A3353MDMDPhysical Therapy Assistant
TEI002441PAMDPhysical Therapy Assistant
2079983TXMDPhysical Therapy Assistant
2306602498VAMDPhysical Therapy Assistant
21997FLMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1700046794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 TANGLEWOOD DR",
            "city": "MARION",
            "state": "KY",
            "postal_code": "420641913",
            "telephone_number": "270-969-0442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 TANGLEWOOD DR",
            "city": "MARION",
            "state": "KY",
            "postal_code": "420641913",
            "telephone_number": "270-969-0442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNN",
        "first_name": "VICKI",
        "middle_name": "D",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-12",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "KY",
            "license": "A02411",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "9688",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TEI002441",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2079983",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "2403",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306602498",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "DC",
            "license": "000001",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A3353",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "005420",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "21997",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; 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.