Brenda Kimak, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2095590 Issued in TX

Practice address

101 N Upper Broadway St
Corpus Christi, TX 78401-2756

Phone

(877) 787-3422

NPI assigned

Oct 11, 2022

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

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": "1665446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1841915824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13845 LONGBOAT DR",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784186142",
            "telephone_number": "630-479-4197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N UPPER BROADWAY ST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784012756",
            "telephone_number": "877-787-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMAK",
        "first_name": "BRENDA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-11",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2095590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Kim, DPT
• Bo Rum Kim, MD
• Jae Doo Kim, M.D.
• Kyurim Kim
• Seunghwan Kim, MD
• Eva Kimble, RN, CMGT-BC, IBCLC
• Julia Clark Kimbrell
• Dana C Kincaid Ensign, FNP-C
• Bradley Eugene King, RN
• Christopher Anthony King

• Physical Therapy Assistant in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; 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.