Individual provider Active NPI

Kayla Dionysus Bunts, PTA

  • Physical Therapy Assistant
  • Grand Chute, WI
National Provider Identifier
1871275917
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2946-19 Issued in WI
Practice address
4026 Towne Lakes Cir Apt 2208
Grand Chute, WI 54913-8110
Phone
(920) 382-2236
NPI assigned
Aug 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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 2946-19 WI Primary

Addresses

Primary practice location

4026 Towne Lakes Cir Apt 2208
Grand Chute, WI 54913-8110

Mailing address

4026 Towne Lakes Cir Apt 2208
Grand Chute, WI 54913-8110
Phone (920) 382-2236

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
2946-19WIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1871275917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4026 TOWNE LAKES CIR APT 2208",
            "city": "GRAND CHUTE",
            "state": "WI",
            "postal_code": "549138110",
            "telephone_number": "920-382-2236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4026 TOWNE LAKES CIR APT 2208",
            "city": "GRAND CHUTE",
            "state": "WI",
            "postal_code": "549138110",
            "telephone_number": "920-382-2236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIONYSUS BUNTS",
        "first_name": "KAYLA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "2946-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Chute, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.