Keith Childs, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2101460 Issued in TX

Practice address

1717 Norfolk Ave
Lubbock, TX 79416-6099

Phone

(806) 281-6117

NPI assigned

Apr 10, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397088000000",
    "number": "1730508490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 NORFOLK AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794166099",
            "telephone_number": "806-281-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 NORFOLK AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794166099",
            "telephone_number": "806-281-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDS",
        "first_name": "KEITH",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-10",
        "last_updated": "2014-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2101460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Children'S Connections, Inc.
• Children'S Home of Lubbock & Family Services Agency, Inc.
• Children'S Hope Residential Services, Inc.
• Children'S Hope Residential Services, Inc.
• Allison Ann Childress, MS, RD, LD
• Jason Min Jae Chin, MD
• Kelly Chisholm
• Paul D Chisholm, M.D.
• Mark Allen Chisum, ATC LAT
• Hyewon Choi

• Physical Therapy Assistant in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.