Katie Jo Clodfelter, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160004650 Issued in IL

Practice address

801 N Logan Ave
Danville, IL 61832-3715

Phone

(217) 443-3106

Fax

(217) 443-3187

NPI assigned

Jul 10, 2012

Last updated

Jul 10, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341878400000",
    "number": "1063777613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 OLD BRUCEVILLE RD",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475913889",
            "telephone_number": "812-886-4677",
            "fax_number": "812-886-4678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N LOGAN AVE",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618323715",
            "telephone_number": "217-443-3106",
            "fax_number": "217-443-3187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLODFELTER",
        "first_name": "KATIE",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-10",
        "last_updated": "2012-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160004650",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06004433A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Clausius
• Thomas Dale Clay, LCSW
• Michael Ray Clayton, PH.D.
• Lisa L Clemons, MSW, LSW
• Clinical Pathology Associates
• Lynda Coffing, R.PH.
• Christina Cole, FNP-BC, AGACNP-BC
• Janay Collier, DC
• Mark Alan Combs, M.S., L.C.P.C.
• Theodore Joseph Commons, RPH, MS

• Physical Therapy Assistant in Danville, IL
• Providers in Danville, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; 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.