Kevin Wilson Small, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1210 Issued in NH

Practice address

175 Blueberry LN
Laconia, NH 03246-2918

Phone

(603) 524-3340

NPI assigned

Aug 20, 2015

Last updated

Aug 20, 2015By the provider in NPPES

Sex

Male

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": "1440028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440028800000",
    "number": "1891161139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 RIDGEMONT DR",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533103",
            "telephone_number": "603-851-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 BLUEBERRY LN",
            "city": "LACONIA",
            "state": "NH",
            "postal_code": "032462918",
            "telephone_number": "603-524-3340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "KEVIN",
        "middle_name": "WILSON",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-20",
        "last_updated": "2015-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NH",
            "license": "1210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gurpinder Singh, MD
• Long Hin Siu
• Christine Slattery
• Joseph Ryan Slaughter, MD
• Laura M Slosman, MLADC
• Terry Maye Smart-Bluhm, MA
• Tara Smith
• Sarah Smolen
• Sobriety Centers of New Hampshire
• Arneli Solidum, MD

• Physical Therapy Assistant in Laconia, NH
• Providers in Laconia, NH by specialty
• Physical Therapy Assistant in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; 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.