Kennia Abigail Nolan, PT, DPT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT4808 Issued in AR

Practice address

105 S Blair St
Springdale, AR 72764

Phone

(479) 259-2339

NPI assigned

Jun 6, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Dr. Kennia Abigail Merlos Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kids Spot LLC

  • Physical Therapy Clinic/Center
  • Springdale, AR
  • NPI 1174845358

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1932638756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6211 CORD AVE",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727621815",
            "telephone_number": "479-685-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S BLAIR ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "72764",
            "telephone_number": "479-259-2339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2915 S D St",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "727580105",
            "country_code": "US",
            "telephone_number": "479-685-3180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "KENNIA",
        "middle_name": "ABIGAIL",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-06",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AR",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT4808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "fusionwebclinic.com",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "105 S Blair St",
            "city": "Springdale",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727644410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KENNIA",
            "last_name": "MERLOS",
            "middle_name": "ABIGAIL",
            "prefix": "DR.",
            "credential": "PT,DPT, ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kyra Drewery Nielsen, COTA/L
• Nine Two Six, Inc (Oliver Pediatric Therapy Services)
• Melanie F Nix, LAC
• No Bad Days LLC
• Noble Elite Telemonitoring Services, LLC
• Kayla Norbash, LMSW
• Christin Norman, LPC
• Emily Norris, PT, DPT
• Mikayleigh J Norris
• Ramona G Norris, R.D.H.

• Physical Therapist in Springdale, AR
• Providers in Springdale, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.