Sally Teresa Vickery, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

001498 Issued in IA

Practice address

2524 Glenn Ave
Sioux City, IA 51106-2768

Phone

(712) 226-2253

Fax

(712) 226-2254

NPI assigned

Jan 8, 2018

Last updated

Jan 8, 2018By 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

Other names 1

• Sally Teresa Kucera Former name

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.

• Children's Care Hospital and School Dba Lifescape

  • Occupational Therapist
  • Sioux City, IA
  • NPI 1114256161
  NPD (past)
• Children's Care Hospital and School

  • Rehabilitation Clinic/Center
  • Rapid City, SD
  • NPI 1174722169
  NPD (past)

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

{
    "created_epoch": "1515369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515369600000",
    "number": "1821505124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2514 CANTERBURY RD",
            "city": "SERGEANT BLUFF",
            "state": "IA",
            "postal_code": "510549766",
            "telephone_number": "712-251-7029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2524 GLENN AVE",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511062768",
            "telephone_number": "712-226-2253",
            "fax_number": "712-226-2254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERY",
        "first_name": "SALLY",
        "middle_name": "TERESA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-08",
        "last_updated": "2018-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IA",
            "license": "001498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SALLY",
            "last_name": "KUCERA",
            "middle_name": "TERESA",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kimberly Kay Velk, PA
• Stephen Leo Venne, P.T.
• William Nolley Vereen III, D.O.
• Thaddeaus Vernon V, M.D.
• Amanda Joy Versteeg, CRNA
• Crystal Vigdal, DNAP, RN, CRNA
• Vision Care Clinic, P.C.
• Vision World Inc (Vision World)
• Jeremy A Vitamvas, PA
• Katharine J. Vlach, MSPT

• Physical Therapy Assistant in Sioux City, IA
• Providers in Sioux City, IA by specialty
• Physical Therapy Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.

Verify at the official NPI Registry.