Active NPI
Nicole Tennant, PTA
- Physical Therapy Assistant
- El Centro, CA
National Provider Identifier
1841699741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 10937
- Practice address
- 2610 Thomas Dr
El Centro, CA 92243-7512 - Phone
- (484) 764-4529
- NPI assigned
- Aug 15, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | TE010264 | PA | |
| Physical Therapy Assistant | 225200000X | 10937 | CA | Primary |
Addresses
Primary practice location
2610 Thomas Dr
El Centro, CA 92243-7512
Mailing address
2610 Thomas Dr
El Centro, CA 92243-7512
Phone (484) 764-4529
Other practice location 1
613 W Allen st
Allentown, PA 18102
Phone (484) 764-4529
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 |
|---|---|---|---|
| 10937 | CA | MD | Physical Therapy Assistant |
| TE010264 | PA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614729600000",
"number": "1841699741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2610 THOMAS DR",
"city": "EL CENTRO",
"state": "CA",
"postal_code": "922437512",
"telephone_number": "484-764-4529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2610 THOMAS DR",
"city": "EL CENTRO",
"state": "CA",
"postal_code": "922437512",
"telephone_number": "484-764-4529"
}
],
"practiceLocations": [
{
"address_1": "613 W Allen st",
"address_purpose": "LOCATION",
"city": "Allentown",
"state": "PA",
"postal_code": "18102",
"country_code": "US",
"telephone_number": "484-764-4529",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TENNANT",
"first_name": "NICOLE",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-15",
"last_updated": "2021-03-03",
"certification_date": "2021-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "PA",
"license": "TE010264",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "10937",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Centro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.