Kellie Blevins

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

AT3525 Issued in CA

Practice address

2540 Carmichael Way
Carmichael, CA 95608-5314

Phone

(916) 482-0465

NPI assigned

Dec 29, 2014

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": "1419811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419811200000",
    "number": "1962890921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3321 OSELOT WAY",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956706980",
            "telephone_number": "916-606-1443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2540 CARMICHAEL WAY",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956085314",
            "telephone_number": "916-482-0465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEVINS",
        "first_name": "KELLIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-29",
        "last_updated": "2014-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT3525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Black White Logistics, LLC
• Erika Lee Black-Mary
• Natalia Black, MD
• Gregory Blair, M.D.
• Beth Blakely, D.C.
• Sharon Blevins
• Blueberry Hill Senior Living, Inc.
• Benjamin Evan Bluth, M.D.
• Joanna Malgorzata Bodas, M.S, CCC-SLP
• Shannon M Boddy, OTR/L

• Physical Therapy Assistant in Carmichael, CA
• Providers in Carmichael, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2014; 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.