Individual provider Active NPI

Kaitlin K McDade, PT

  • Physical Therapist
  • Memphis, TN
National Provider Identifier
1104771690
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16879 Issued in TN
Practice address
1785 Nonconnah Blvd Ste 108
Memphis, TN 38132-2139
Phone
(901) 344-0101
NPI assigned
Mar 2, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 16879 TN Primary

Addresses

Primary practice location

1785 Nonconnah Blvd Ste 108
Memphis, TN 38132-2139

Mailing address

3884 Stone Hill Dr
Bartlett, TN 38135-3200
Phone (901) 427-5074

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
16879TNMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1772409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1104771690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3884 STONE HILL DR",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381353200",
            "telephone_number": "901-427-5074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1785 NONCONNAH BLVD STE 108",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381322139",
            "telephone_number": "901-344-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDADE",
        "first_name": "KAITLIN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-02",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "16879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; 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.