Kimberly Fraser, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160006488 Issued in IL

Practice address

620 Warrington Ave
Danville, IL 61832-5446

Phone

(217) 444-2842

NPI assigned

Jan 18, 2022

Sex

Female

Sole proprietor

No

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": "1642464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1982355285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 MILL RD",
            "city": "GEORGETOWN",
            "state": "IL",
            "postal_code": "618466005",
            "telephone_number": "217-553-8628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 WARRINGTON AVE",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618325446",
            "telephone_number": "217-444-2842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRASER",
        "first_name": "KIMBERLY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-18",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160006488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zakkary Forsyth, LCSW
• Elissa Jo Fortna, MSW
• Rebecca Francis, LCSW
• Siby Francis, O.D
• Kassidi Rae Franzen, LSW
• Rene Ann Frasher, DHSC, PA-C
• Reylla Cristina Freire DO Vale Santos, PHD, LCPC
• Gerald Dewayne French
• Courtney Natalie Rae Frick, DPT
• Michelle Anne Friedlund, BS

• Physical Therapy Assistant in Danville, IL
• Providers in Danville, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.