Individual provider Active NPI

Kyndra Leigh West, PTA

  • Physical Therapy Assistant
  • Blue Ridge, GA
National Provider Identifier
1861987265
Registry record updated Apr 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA004064 Issued in GA
Practice address
990 E Main St Ste 7
Blue Ridge, GA 30513
Phone
(706) 946-2035
Fax
(706) 946-2036
NPI assigned
Jun 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA004064 GA Primary

Addresses

Primary practice location

990 E Main St Ste 7
Blue Ridge, GA 30513

Mailing address

6397 Lee Hwy Ste 300
Chattanooga, TN 37421-2564
Phone (423) 238-7217

Other names 1

  • Kyndra Leigh Payne Professional name

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

LicenseStateTypeSpecialty
PTA004064GAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1861987265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212564",
            "telephone_number": "423-238-7217",
            "fax_number": "423-362-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 E MAIN ST STE 7",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "30513",
            "telephone_number": "706-946-2035",
            "fax_number": "706-946-2036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEST",
        "first_name": "KYNDRA",
        "middle_name": "LEIGH",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA004064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYNDRA",
            "last_name": "PAYNE",
            "middle_name": "LEIGH",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Blue Ridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; 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.