Cheyenne S Price, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

06005864A Issued in IN

Practice address

3630 Hickory Rd
Mishawaka, IN 46545-8865

Phone

(574) 252-7225

NPI assigned

Jul 27, 2020

Last updated

Jul 27, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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)

Enrolled

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1750990610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30595 SPRING MEADOW CT",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465305894",
            "telephone_number": "574-386-5052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 HICKORY RD",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465458865",
            "telephone_number": "574-252-7225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRICE",
        "first_name": "CHEYENNE",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-27",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06005864A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethann Pradny, AGAC-NP BC
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• Preventive Medicine, PC
• Mark Paul Priebe, M.D.
• Timothy Primrose, NP
• Privia Medical Group Indiana, LLC
• Privia Medical Group Indiana, LLC
• Progressive Pediatric Therapy Inc.

• Physical Therapy Assistant in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Physical Therapy Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; 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.