Active NPI
Vicki D Lynn, PTA
- Physical Therapy Assistant
- Marion, KY
National Provider Identifier
1700046794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A02411
- Practice address
- 202 Tanglewood Dr
Marion, KY 42064-1913 - Phone
- (270) 969-0442
- NPI assigned
- Jun 12, 2008
- Last updated
- Jan 21, 2014
- 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 10
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 9688 | CA | MD | Physical Therapy Assistant |
| 000001 | DC | MD | Physical Therapy Assistant |
| 005420 | IL | MD | Physical Therapy Assistant |
| A02411 | KY | MD | Physical Therapy Assistant |
| A3353 | MD | MD | Physical Therapy Assistant |
| TEI002441 | PA | MD | Physical Therapy Assistant |
| 2079983 | TX | MD | Physical Therapy Assistant |
| 2306602498 | VA | MD | Physical Therapy Assistant |
| 21997 | FL | MD | Occupational 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
- Legacy Oxygen and Home Care Equipment LLC
- Livingston Hospital and Healthcare Services, Inc. (Livingston Health Clinic)
- Livingston Hospital and Healthcare Services, Inc. (Livingston Hospital Family Clinic)
- Livingston Hospital and Healthcare Services, Inc., Cah (Marion Physician's Clinic)
- Bethaney Denise Long, LCSW
- Howard G Maddux, MD
- Jonathan Patmor Maddux, MD
- Marion Eye Care Center PLLC
- Marion Wellness Center PSC
- Melissa Gayle Myers
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.