NPIMap

Individual provider Active NPI

Kathryn Jayne Stedman, P.T.

  • Physical Therapist
  • Malden, MA
National Provider Identifier
1013174424
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0000425 Issued in WA
Practice address
40 Eastern Ave
Malden, MA 02148-5014
Phone
(800) 760-5196
NPI assigned
May 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0000425 WA Primary
Physical Therapist 225100000X OR

Addresses

Primary practice location

40 Eastern Ave
Malden, MA 02148-5014

Mailing address

13708 97TH Ave NE
Kirkland, WA 98034-1874
Phone (425) 829-2639

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
0000425WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cross Country Travcorps Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1013174424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13708 97TH AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980341874",
            "telephone_number": "425-829-2639",
            "fax_number": "425-823-6133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 EASTERN AVE",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485014",
            "telephone_number": "800-760-5196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEDMAN",
        "first_name": "KATHRYN",
        "middle_name": "JAYNE",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-22",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "0000425",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malden, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.