Active NPI
Carla Renee Reeves, PTA
- Physical Therapy Assistant
- Pine Knot, KY
National Provider Identifier
1962846121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 06004606A
- Practice address
- 194 Tom Neal Rd
Pine Knot, KY 42635-9239 - Phone
- (606) 310-3749
- NPI assigned
- Apr 18, 2013
- 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 | 06004606A | IN | Primary |
Addresses
Primary practice location
194 Tom Neal Rd
Pine Knot, KY 42635-9239
Mailing address
194 Tom Neal Rd
Pine Knot, KY 42635-9239
Phone (606) 310-3749
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 |
|---|---|---|---|
| 06004606A | IN | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366243200000",
"number": "1962846121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "194 TOM NEAL RD",
"city": "PINE KNOT",
"state": "KY",
"postal_code": "426359239",
"telephone_number": "606-310-3749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "194 TOM NEAL RD",
"city": "PINE KNOT",
"state": "KY",
"postal_code": "426359239",
"telephone_number": "606-310-3749"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REEVES",
"first_name": "CARLA",
"middle_name": "RENEE",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-04-18",
"last_updated": "2013-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IN",
"license": "06004606A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pine Knot, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.