Active NPI
Kathleen Huttner, PT
- Physical Therapist
- Riverhead, NY
National Provider Identifier
1053365098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 013541
- Practice address
- 883 E Main St
Riverhead, NY 11901-2613 - Phone
- (631) 284-5500
- NPI assigned
- May 22, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 013541 | NY | Primary |
Addresses
Primary practice location
883 E Main St
Riverhead, NY 11901-2613
Mailing address
3 Williams St
Manorville, NY 11949-2605
Phone (631) 874-3573
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060524000061 | NY | Practitioner - Physical Therapist in Private Practice | 8325059710 | Practice locations: Manorville, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186617600000",
"number": "1053365098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 WILLIAMS ST",
"city": "MANORVILLE",
"state": "NY",
"postal_code": "119492605",
"telephone_number": "631-874-3573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "883 E MAIN ST",
"city": "RIVERHEAD",
"state": "NY",
"postal_code": "119012613",
"telephone_number": "631-284-5500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUTTNER",
"first_name": "KATHLEEN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-22",
"last_updated": "2007-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "013541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverhead, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.