Kyra Stewart, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA002654 Issued in WV

Practice address

225 Russell Ave
New Martinsville, WV 26155-1572

Phone

(304) 455-2600

NPI assigned

May 5, 2021

Sex

Female

Sole proprietor

Yes

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": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1902480072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37295 MARIETTA ST",
            "city": "SARDIS",
            "state": "OH",
            "postal_code": "439468718",
            "telephone_number": "304-815-5715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 RUSSELL AVE",
            "city": "NEW MARTINSVILLE",
            "state": "WV",
            "postal_code": "261551572",
            "telephone_number": "304-455-2600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "37295 Marietta St",
            "address_purpose": "LOCATION",
            "city": "Sardis",
            "state": "OH",
            "postal_code": "439468718",
            "country_code": "US",
            "telephone_number": "304-815-5715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEWART",
        "first_name": "KYRA",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-05",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "WV",
            "license": "PTA002654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in New Martinsville, WV
• Providers in New Martinsville, WV by specialty
• Physical Therapy Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; 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.