Individual provider Active NPI

Sharon Lee Kain, PTA

  • Physical Therapy Assistant
  • Polk City, FL
National Provider Identifier
1730363722
Registry record updated Dec 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA1819 Issued in FL
Practice address
452 Clearwater Lake Dr
Polk City, FL 33868-9085
Phone
(352) 615-3404
NPI assigned
Dec 26, 2007
Last updated
Dec 26, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA1819 FL Primary

Addresses

Primary practice location

452 Clearwater Lake Dr
Polk City, FL 33868-9085

Mailing address

452 Clearwater Lake Dr
Polk City, FL 33868-9085
Phone (352) 615-3404

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
PTA1819FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198627200000",
    "number": "1730363722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 CLEARWATER LAKE DR",
            "city": "POLK CITY",
            "state": "FL",
            "postal_code": "338689085",
            "telephone_number": "352-615-3404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 CLEARWATER LAKE DR",
            "city": "POLK CITY",
            "state": "FL",
            "postal_code": "338689085",
            "telephone_number": "352-615-3404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAIN",
        "first_name": "SHARON",
        "middle_name": "LEE",
        "name_prefix": "Miss",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-26",
        "last_updated": "2007-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA1819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Polk City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2007; 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.