Individual provider Active NPI

Kathryn Clarkin Patrick, P.T.

  • Physical Therapist
  • Brevard, NC
National Provider Identifier
1104910124
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1421 Issued in NC
Practice address
Country Club Road
Brevard, NC 28712
Phone
(828) 877-3877
Fax
(828) 877-5160
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1421 NC Primary

Addresses

Primary practice location

Country Club Road
Brevard, NC 28712

Mailing address

306 Vanderbilt Rd
Asheville, NC 28803-2807
Phone (828) 274-2755

Other identifiers 1

IdentifierTypeStateIssuer
079VUOtherNCBLUE CROSS BLUE SHIELD NC

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1421NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Transylvania Aquatic Physical Therapy, Inc. 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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104910124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 VANDERBILT RD",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288032807",
            "telephone_number": "828-274-2755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COUNTRY CLUB ROAD",
            "city": "BREVARD",
            "state": "NC",
            "postal_code": "28712",
            "telephone_number": "828-877-3877",
            "fax_number": "828-877-5160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "KATHRYN",
        "middle_name": "CLARKIN",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "1421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NC",
            "identifier": "079VU",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brevard, NC

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.

Verify at the official NPI Registry.