Individual provider Active NPI

Tracie Carol Tarter, P.T.A.

  • Physical Therapy Assistant
  • Somerset, KY
National Provider Identifier
1902003122
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
AO1119 Issued in KY
Practice address
200 Norfleet Dr
Somerset, KY 42501-1952
Phone
(606) 678-5104
Fax
(606) 677-1925
NPI assigned
Jun 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 AO1119 KY Primary

Addresses

Primary practice location

200 Norfleet Dr
Somerset, KY 42501-1952

Mailing address

512 Hidden Loop Dr
Somerset, KY 42503-9610
Phone (606) 678-8069

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
AO1119KYMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902003122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 HIDDEN LOOP DR",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425039610",
            "telephone_number": "606-678-8069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NORFLEET DR",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425011952",
            "telephone_number": "606-678-5104",
            "fax_number": "606-677-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARTER",
        "first_name": "TRACIE",
        "middle_name": "CAROL",
        "name_prefix": "Mrs.",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "KY",
            "license": "AO1119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.