Kelsey Mikala Leak, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

14-02962 Issued in KS

Practice address

1603 N Chapel Hill St Ste 400
Wichita, KS 67206-5510

Phone

(316) 440-6551

NPI assigned

Mar 7, 2016

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1457308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464912000000",
    "number": "1831559657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 W CENTRAL AVE APT 1707",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672034237",
            "telephone_number": "316-644-7816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 N CHAPEL HILL ST STE 400",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672065510",
            "telephone_number": "316-440-6551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAK",
        "first_name": "KELSEY",
        "middle_name": "MIKALA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-07",
        "last_updated": "2016-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "KS",
            "license": "14-02962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14-02962",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leah Rundle Therapy LLC
• Dean P Leahy, CRNA
• Mary Leahy, CRNA
• Michael Leahy, PSYD
• Denny L Leak
• Rex V Lear, MD
• Valerie Learned
• Michael James Leary, M.ED., L.C.P.C.
• Jennifer Leasure, RN
• Leatanya E Koppa, LLC

• Physical Therapy Assistant in Wichita, KS
• Providers in Wichita, KS by specialty
• Physical Therapy Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2016; 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.