Individual provider Active NPI

Katherine Riley Shore, PT, DPT, ATC

  • Physical Therapist
  • Belville, NC
National Provider Identifier
1144722489
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P24079 Issued in NC
Practice address
497 Olde Waterford Way Ste 102
Belville, NC 28451-4183
Phone
(910) 444-1548
NPI assigned
Mar 2, 2018
Last updated
Nov 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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 P24079 NC Primary
Athletic Trainer 2255A2300X NU

Addresses

Primary practice location

497 Olde Waterford Way Ste 102
Belville, NC 28451-4183

Mailing address

5710 Oleander Dr Ste 211
Wilmington, NC 28403-4722

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250626001602 NC Practitioner - Physical Therapist in Private Practice 9830601558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Zumbro and Connell IncGroup PAC ID 5698852499, 39 clinicians

Practice addresses (Care Compare)

497 Olde Waterford Way
Suite 102
Belville, NC 28451-4183
Phone (910) 444-1548

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P24079NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Zumbro and Connell, Inc Physical Therapist CurrentSince May 20, 2025 Accepting new patients

Locations

497 Olde Waterford Way
Ste 102
Belville, NC 28451
Phone (910) 444-1548

2250 Shipyard Blvd
Ste 14
Wilmington, NC 28403
Phone (910) 518-9951

5710 Oleander Dr
Ste 211
Wilmington, NC 28403
Phone (910) 398-6301

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": "1519948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1144722489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5710 OLEANDER DR STE 211",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "497 OLDE WATERFORD WAY STE 102",
            "city": "BELVILLE",
            "state": "NC",
            "postal_code": "284514183",
            "telephone_number": "910-444-1548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORE",
        "first_name": "KATHERINE",
        "middle_name": "RILEY",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-02",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P24079",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; 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.