KELLY JEAN DETHERAGE


Address: 1201 Holland Lake Drive, Weatherford, TX 76086
Phone: 8176139699

KELLY JEAN DETHERAGE (NPI# 1245543966) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1245543966
Entity Type Individual
Full Name KELLY JEAN DETHERAGE
Credential PTA
Practice Address 1201 Holland Lake Drive
Weatherford
TX 76086
Mailing Address 4560 Se International Way
Ste. 100
Milwaukie
OR 97222
Practice Telephone 8176139699
Practice Fax Number 8175949786
Mailing Telephone 9712065200
Mailing Fax Number 9712065203
Enumeration Date 2010-07-22
Last Update Date 2010-07-22
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 225200000X Physical Therapy Assistant 2076950 TX Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Other Providers KELLY DETHERAGE

NPI Name Taxonomy Address Enumeration
1497167845 Kelly Detherage Case Manager/Care Coordinator 601 W Michigan St, Orlando, FL 32805-6203 2014-05-20

Office Location

Street Address 1201 HOLLAND LAKE DRIVE
City WEATHERFORD
State TX
Zip Code 76086

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1104434810 Beverly Diana Blair Licensed Vocational Nurse 870 Columbia Drive, Weatherford, Weatherford, TX 76086 2020-07-20
1275027385 Star Family Medicine Pllc Family Medicine 933 Hilltop Dr Ste 100, Weatherford, TX 76086 2018-06-21
1174011324 Anuj Yogesh Vyas Student in an Organized Health Care Education/Training Program Medical City Weatherford 713 E. Anderson, Weatherford, TX 76086 2018-04-24
1003321068 Kleven Chiropractic, LLC Chiropractor 925 Santa Fe Drive, Suite #111, Weatherford, TX 76086 2017-12-12
1417471467 Weatherford Health Services, LLC General Acute Care Hospital 713 East Anderson Street, Weatherford, TX 76086 2017-08-01
1710401021 Kyle Evan Meason Dentist 2035 Fort Worth Hwy Ste 600, Weatherford, TX 76086 2017-07-28
1457898520 Apmd LLC Clinic/Center 110 W I-20 Frontage Rd, Suite 130, Weatherford, TX 76086 2017-01-26
1861934887 Laura Neel Occupational Therapist 250 Sante Fe Dr, Weatherford, TX 76086 2016-11-08
1588022040 Heather Goddard Nurse Practitioner 920 Sante Fe Drive, Weatherford, TX 76086 2016-01-29
1689049413 The Dermatology Spot Pllc Dermatology 1841 Martin Dr, 200, Weatherford, TX 76086 2015-12-04
Find all providers in zip 76086

Taxonomy Information

Taxonomy Code 225200000X
Grouping Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification Physical Therapy Assistant

Taxonomy Definition

(1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of the physical therapist assistant. The PTA performs physical therapy procedures and related tasks that have been selected and delegated by the supervising physical therapist. Duties of the PTA include assisting the physical therapist in implementing treatment programs, training patients in exercised and activities of daily living, conducting treatments, and reporting to the physical therapist on the patient’s responses. In addition to direct patient care, the PTA may also perform such functions as patient transport, and clinic or equipment preparation and maintenance. Currently more than half of all states require PTAs to be licensed, registered or certified. (2) An individual who works under the supervision of a physical therapist to assist him or her in providing physical therapy services. A physical therapy assistant may, for instance, help patients follow an appropriate exercise program that will increase their strength, endurance, coordination, and range of motion and train patients to perform activities of daily life.
Notes: Source: (1) American Physical Therapy Association, P.O. Box 37257, Washington, D.C. 20013. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1154965770 Alison E Smith Physical Therapy Assistant 119 Mike Thornton Ct, Weatherford, TX 76088 2019-11-06
1750845939 Britney B Pollok Physical Therapy Assistant 1102 Dennis Rd, Weatherford, TX 76087-8826 2019-01-22
1992289714 Jahel Quintana-correa Physical Therapy Assistant 3707 Stonebridge Dr, Weatherford, TX 76085-8203 2018-09-18
1992288179 Henrietta Hall Physical Therapy Assistant 1724 Martin Dr Apt 6205, Weatherford, TX 76086-6291 2018-09-13
1326529694 Jenny Jay Lowe Physical Therapy Assistant 911 Terry Trl, Weatherford, TX 76086-4645 2018-08-24
1376020727 Jill Wilson Physical Therapy Assistant 208 N Main St Ste 130, Weatherford, TX 76086-3267 2018-07-27
1710368709 Enrique Jr Pinzon Bucoy Physical Therapy Assistant 502 N Main St Unit 3014, Weatherford, TX 76086-2462 2015-06-15
1912160003 Amber Claussen Physical Therapy Assistant 1205 Santa Fe Dr, Weatherford, TX 76086-5819 2008-07-08
1740815059 Mary- Kate Morissette Physical Therapy Assistant 208 N Main St Ste 130, Weatherford, TX 76086-3267 2020-03-06
1023643327 Antonio Fleming Physical Therapy Assistant 208 N Main St Ste 130, Weatherford, TX 76086-3267 2020-03-06
Find all providers in WEATHERFORD

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City WEATHERFORD
Zip Code 76086

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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