Individual provider Active NPI

Katelyn Richards, DPT

  • Physical Therapist
  • Turlock, CA
National Provider Identifier
1114567682
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10270 Issued in SC
Practice address
1801 N Olive Ave
Turlock, CA 95382-2568
Phone
(209) 410-7390
NPI assigned
Jan 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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 10270 SC Primary

Addresses

Primary practice location

1801 N Olive Ave
Turlock, CA 95382-2568

Mailing address

1801 N Olive Ave
Turlock, CA 95382-2568

Other practice location 1

1801 N Olive Ave
Turlock, CA 95382-2568
Phone (209) 410-7390

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200929003722 SC Practitioner - Physical Therapist in Private Practice 1557780244 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10270SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Physical Therapy LLC Physical Therapist CurrentSince Jan 19, 2025 Accepting new patients
Fox Rehabilitation Services of South Carolina, LLC Physical Therapist CurrentSince Sep 1, 2020 Accepting new patients

Locations

64 Bluffton Rd
Bluffton, SC 29910
Phone (843) 681-2376

1510 Ribaut Rd
Port Royal, SC 29935
Phone (843) 524-3241

Organizations & group practices 2

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": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1114567682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 N OLIVE AVE",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953822568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N OLIVE AVE",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953822568",
            "telephone_number": "209-410-7390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 N Olive Ave",
            "address_purpose": "LOCATION",
            "city": "Turlock",
            "state": "CA",
            "postal_code": "953822568",
            "country_code": "US",
            "telephone_number": "209-410-7390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "KATELYN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-13",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "10270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Turlock, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; 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.