Active NPI
Kristy Gates
- Physical Therapy Assistant
- McComb, MS
National Provider Identifier
1891942991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 3347
- Practice address
- 206 Maryland Ave
McComb, MS 39648-3926 - Phone
- (601) 250-4815
- NPI assigned
- Aug 20, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 3347 | MS | Primary |
Addresses
Primary practice location
206 Maryland Ave
McComb, MS 39648-3926
Mailing address
3349 Bobby Gates LN SE
Bogue Chitto, MS 39629-9617
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 |
|---|---|---|---|
| 3347 | MS | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219190400000",
"number": "1891942991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3349 BOBBY GATES LN SE",
"city": "BOGUE CHITTO",
"state": "MS",
"postal_code": "396299617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 MARYLAND AVE",
"city": "MCCOMB",
"state": "MS",
"postal_code": "396483926",
"telephone_number": "601-250-4815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GATES",
"first_name": "KRISTY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-20",
"last_updated": "2008-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MS",
"license": "3347",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McComb, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.