Individual provider Active NPI

Maggie Mae Musgrave, PTA

  • Physical Therapy Assistant
  • Killeen, TX
National Provider Identifier
1992430888
Registry record updated Jul 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2170154 Issued in TX
Practice address
5302 Janelle Dr
Killeen, TX 76549-5666
Phone
(254) 699-3933
NPI assigned
Jul 24, 2022
Last updated
Jul 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2170154 TX Primary

Addresses

Primary practice location

5302 Janelle Dr
Killeen, TX 76549-5666

Mailing address

2010 Red Fox Dr
Nolanville, TX 76559-4583

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

LicenseStateTypeSpecialty
2170154TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1658620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658620800000",
    "number": "1992430888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 RED FOX DR",
            "city": "NOLANVILLE",
            "state": "TX",
            "postal_code": "765594583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5302 JANELLE DR",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765495666",
            "telephone_number": "254-699-3933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSGRAVE",
        "first_name": "MAGGIE",
        "middle_name": "MAE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-24",
        "last_updated": "2022-07-24",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2170154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Killeen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.