Active NPI
Dana Nicole Hutson, PTA
- Physical Therapy Assistant
- Texarkana, TX
National Provider Identifier
1780102228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2109412
- Practice address
- 1315 Walnut St
Texarkana, TX 75501-4446 - Phone
- (903) 794-2705
- Fax
- (903) 794-2705
- NPI assigned
- Sep 5, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2109412 | TX | Primary |
Addresses
Primary practice location
1315 Walnut St
Texarkana, TX 75501-4446
Mailing address
2348 US Highway 259 N
De Kalb, TX 75559-4260
Phone (903) 219-1665
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 021289601 | Medicaid | TX |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2109412 | TX | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Temple Memorial Pediatric Center Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Texarkana, TX
- NPI 1972654663
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1780102228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2348 US HIGHWAY 259 N",
"city": "DE KALB",
"state": "TX",
"postal_code": "755594260",
"telephone_number": "903-219-1665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1315 WALNUT ST",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755014446",
"telephone_number": "903-794-2705",
"fax_number": "903-794-2705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUTSON",
"first_name": "DANA",
"middle_name": "NICOLE",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-05",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2109412",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "021289601",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Texarkana, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.