Katherine Lorraine Waters, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

294964 Issued in CA

Practice address

3704 Ruffin Rd
San Diego, CA 92123-1812

Phone

(619) 930-9750

NPI assigned

Jul 10, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Katherine Lorraine Haltiwanger Former name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/30366/brand/1/csg/1/fhir/r4

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.

• Austin Sports Medicine LLP

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Austin, TX
  • NPI 1770553653
  Medicare reassignment NPD
• DPT Holdings PLLC

  • Physical Therapist
  • Plainfield, IL
  • NPI 1689648602
  NPD

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1093201378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 CONNECTICUT ST",
            "city": "IMPERIAL BEACH",
            "state": "CA",
            "postal_code": "919323223",
            "telephone_number": "619-930-9750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3704 RUFFIN RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231812",
            "telephone_number": "619-930-9750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2323 E 8th St",
            "address_purpose": "LOCATION",
            "city": "National City",
            "state": "CA",
            "postal_code": "919502813",
            "country_code": "US",
            "telephone_number": "619-323-9204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATERS",
        "first_name": "KATHERINE",
        "middle_name": "LORRAINE",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-10",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "294964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE NUMBER",
            "identifier": "294964",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "HALTIWANGER",
            "middle_name": "LORRAINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elyse Nicole Waters
• Gabriela Riviello Waters, NP
• Geena Waters
• Heather Waters, PT, DPT
• Jocelyn A Waters, RN
• Valerie Waters, NP-C
• Jessica Karas Waterson, L.M.F.T
• Carmelita Wathen
• Paul C Wathern
• Julie Watkins-Torry, M.D.

• Physical Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; 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.

Verify at the official NPI Registry.