Kelly Eileen Nugent

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2056880 Issued in TX

Practice address

17751 Park Valley Dr
Round Rock, TX 78681-3592

Phone

(512) 218-6013

NPI assigned

Aug 23, 2018

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

Other identifiers 1

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": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1962983460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8525 SHOAL CREEK BLVD APT 102",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787577554",
            "telephone_number": "512-679-7957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17751 PARK VALLEY DR",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786813592",
            "telephone_number": "512-218-6013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUGENT",
        "first_name": "KELLY",
        "middle_name": "EILEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-23",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2056880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF PHYSICAL THERAPY EXAMINERS",
            "identifier": "2056880",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rabih Nour, MD
• Novacare Home Health Services
• Jacqueline Rae Nowicki, PT, DPT
• Thongsamuth Noymany, PHARMD
• Brisly Ntoh
• Shanti Nulu, MD
• Estibaliz Nunez
• Lucero Melissa Nunez, MS, BCBA
• Lee James Nunn, RD
• Nutrition by Natalie, LLC

• Physical Therapy Assistant in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; 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.