Active NPI
Katherine Reardon, P.T., D.P.T.
- Physical Therapist
- Farmington, NM
National Provider Identifier
1073539722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3403
- Practice address
- 3832 E Main St
Units E and F
Farmington, NM 87402-8749 - Phone
- (505) 564-2955
- Fax
- (505) 564-2662
- NPI assigned
- Jul 14, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 9029 | CO | |
| Physical Therapist | 225100000X | 3403 | NM | Primary |
Addresses
Primary practice location
3832 E Main St
Units E and F
Farmington, NM 87402-8749
Mailing address
7111 Dellwood CT
Farmington, NM 87402-5045
Phone (505) 327-5533
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9029 | CO | MD | Physical Therapist |
| 3403 | NM | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Four Corners Physical Therapy Limited Partnership | Physical Therapist | 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.
-
- Physical Therapy Clinic/Center
- Farmington, NM
- NPI 1073534194
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073539722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7111 DELLWOOD CT",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874025045",
"telephone_number": "505-327-5533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3832 E MAIN ST",
"address_2": "UNITS E AND F",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874028749",
"telephone_number": "505-564-2955",
"fax_number": "505-564-2662"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REARDON",
"first_name": "KATHERINE",
"credential": "P.T., D.P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "9029",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "3403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.