Haley Marie Kearby, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160.008476 Issued in IL

Practice address

1 Professional Dr
Alton, IL 62002-5068

Phone

(618) 462-4621

NPI assigned

Nov 30, 2018

Sex

Female

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Omni Physical Therapy, LLC

  • Physical Therapist
  • Des Peres, MO
  • NPI 1184877672
  NPD (past)

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

{
    "created_epoch": "1543536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1770053928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 DES PERES RD STE 130",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312050",
            "telephone_number": "314-775-0183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PROFESSIONAL DR",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620025068",
            "telephone_number": "618-462-4621"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Des Peres Rd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631312050",
            "country_code": "US",
            "telephone_number": "314-775-0183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEARBY",
        "first_name": "HALEY",
        "middle_name": "MARIE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-30",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.008476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janice Kang, BA
• Philip D Kannel, DO
• Wendy Kapp, BS
• Ahmad A Karadaghy, M.D.
• Laura L Kaupas, MSW, LCSW, CADC/MISA
• Sandra Kearns, BS
• John Robert J Keller, D.M.D.
• Christa D Kelly, PT
• Molly Marie Kemner, MAT, ATC
• Sohaib Muhammad Khan, MD

• Physical Therapy Assistant in Alton, IL
• Providers in Alton, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.