Trudy Mae Davidson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA1659 Issued in AR

Practice address

3291 S Thompson St Ste C103
Springdale, AR 72764-7343

Phone

(479) 750-3535

Fax

(479) 750-3539

NPI assigned

Apr 6, 2011

Last updated

Apr 6, 2011By the provider in NPPES

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Physician's Therapy Group, LLC

  • Speech-Language Pathologist
  • Springdale, AR
  • NPI 1144276585

  Physical Therapy Assistant

  NPD (past)

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302048000000",
    "number": "1801185251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 LAKE RD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727642508",
            "telephone_number": "479-750-3535",
            "fax_number": "479-750-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3291 S THOMPSON ST STE C103",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727647343",
            "telephone_number": "479-750-3535",
            "fax_number": "479-750-3539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "TRUDY",
        "middle_name": "MAE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-06",
        "last_updated": "2011-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "PTA1659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Jordan Daniels
• Mikel Dashtipour, PA
• Leah Dianne Davenport, PTA
• David R Massey MD PLLC
• Ryan Taylor Davidson, PT, DPT
• Latandria Davie
• Jacob Thomas Davies, PT, DPT
• Daniel Davis, NP-C
• David A Davis, M.D.
• Hollyn Davis

• Physical Therapy Assistant in Springdale, AR
• Providers in Springdale, AR by specialty
• Physical Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2011; 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.