Individual provider Active NPI

Kristie L. Latka, PT

  • Physical Therapist
  • Beloit, WI
National Provider Identifier
1124487269
Registry record updated Feb 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5408-24 Issued in WI
Practice address
1969 W Hart Rd
Beloit Health System Inc
Beloit, WI 53511-2230
Phone
(608) 364-5173
Fax
(608) 363-5790
NPI assigned
Feb 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5408-24 WI Primary
Physical Therapist 225100000X 070-009874 IL

Addresses

Primary practice location

1969 W Hart Rd
Beloit Health System Inc
Beloit, WI 53511-2230

Mailing address

1905 E Huebbe Pkwy
Beloit Health System Inc
Beloit, WI 53511-1842
Phone (608) 364-2200

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
070-009874ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Beloit Health System Inc CurrentSince Oct 6, 2024 Accepting new patients
Beloit Health System, Inc CurrentSince Oct 6, 2024 Accepting new patients
Beloit Clinic, S.C. Current Accepting new patients

Locations

1905 E Huebbe Pkwy
Beloit, WI 53511
Phone (608) 364-2293

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

1735 Madison Rd
Beloit, WI 53511
Phone (608) 363-7510

Organizations & group practices 3

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": "1455667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455667200000",
    "number": "1124487269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 E HUEBBE PKWY",
            "address_2": "BELOIT HEALTH SYSTEM INC",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111842",
            "telephone_number": "608-364-2200",
            "fax_number": "608-363-7395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1969 W HART RD",
            "address_2": "BELOIT HEALTH SYSTEM INC",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535112230",
            "telephone_number": "608-364-5173",
            "fax_number": "608-363-5790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATKA",
        "first_name": "KRISTIE",
        "middle_name": "L.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-17",
        "last_updated": "2016-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "5408-24",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-009874",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beloit, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; 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.