Individual provider Active NPI

Kerry Caddell, PT, DPT

  • Physical Therapist
  • Cincinnati, OH
National Provider Identifier
1003433673
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT018692 Issued in OH
Practice address
6210 Cleves Warsaw Pike
Cincinnati, OH 45233-4510
Phone
(513) 941-0099
NPI assigned
Jun 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT018692 OH Primary

Addresses

Primary practice location

6210 Cleves Warsaw Pike
Cincinnati, OH 45233-4510

Mailing address

5809 Gold Dust Dr
Cincinnati, OH 45247-5994
Phone (513) 403-5435

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL kerry.caddell5@gmail.com Direct

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
PT018692OHMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1003433673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5809 GOLD DUST DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452475994",
            "telephone_number": "513-403-5435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6210 CLEVES WARSAW PIKE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452334510",
            "telephone_number": "513-941-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CADDELL",
        "first_name": "KERRY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-30",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT018692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "kerry.caddell5@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5809 Gold Dust Dr",
            "city": "Cincinnati",
            "state": "OH",
            "country_code": "US",
            "postal_code": "452475994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; 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.