Individual provider Active NPI

Katy Mulligan Weddell, P.T.

  • Physical Therapist
  • Chestertown, MD
National Provider Identifier
1114067428
Registry record updated Feb 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
17921 Issued in MD
Practice address
210 S Cross St
Suite 103
Chestertown, MD 21620-1569
Phone
(410) 778-3900
NPI assigned
Feb 7, 2007
Last updated
Feb 28, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2014

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 17921 MD Primary

Addresses

Primary practice location

210 S Cross St
Suite 103
Chestertown, MD 21620-1569

Mailing address

210 S Cross St
Suite 103
Chestertown, MD 21620-1569
Phone (410) 778-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071004000501 MD Practitioner - Physical Therapist in Private Practice 9335234442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Maryland School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

210 S Cross St
Suite 103
Chestertown, MD 21620-1581
Phone (410) 778-3900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17921MDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Chesapeake Physical Therapy, LLC Physical Therapist CurrentSince Sep 1, 2007 Accepting new patients

Locations

210 S Cross St
Ste 103
Chestertown, MD 21620
Phone (410) 778-3900

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: katy.weddell@cptl-md.direct.office.nextgen.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393545600000",
    "number": "1114067428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S CROSS ST",
            "address_2": "SUITE 103",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216201569",
            "telephone_number": "410-778-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S CROSS ST",
            "address_2": "SUITE 103",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216201569",
            "telephone_number": "410-778-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEDDELL",
        "first_name": "KATY",
        "middle_name": "MULLIGAN",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2014-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "17921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chestertown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.