Maumelle Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT2475 Issued in AR

Legal business name

MAUMELLE PHYSICAL THERAPY

Practice address

9843 Maumelle Blvd
North Little Rock, AR 72113-7027

Phone

(501) 851-6600

Fax

(501) 851-6643

NPI assigned

Nov 30, 2005

Last updated

Feb 17, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kenny A De Luca, P.T.NPI 1114901451

Title

Owner

Phone

(501) 753-2201

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenny A De Luca, P.T.

  • Physical Therapist
  • North Little Rock, AR
  • NPI 1114901451
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266364800000",
    "number": "1730163072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13567",
            "city": "MAUMELLE",
            "state": "AR",
            "postal_code": "721130567",
            "telephone_number": "501-753-2201",
            "fax_number": "501-753-2207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9843 MAUMELLE BLVD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721137027",
            "telephone_number": "501-851-6600",
            "fax_number": "501-851-6643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAUMELLE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-30",
        "last_updated": "2010-02-17",
        "status": "A",
        "authorized_official_last_name": "DE LUCA",
        "authorized_official_first_name": "KENNY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-753-2201",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT2475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157828742",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BCBS",
            "identifier": "5F332",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kathleen May, R.N.
• Susan May

• Physical Therapist in North Little Rock, AR
• Providers in North Little Rock, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.