Individual provider Active NPI

Katherine O'Donnell, D.P.T.

  • Physical Therapist
  • Kapa'a, HI
National Provider Identifier
1154892511
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-4833 Issued in HI
Practice address
5633 Kawaihu Road
BLDG 2a-12
Kapaa, HI 96746
Phone
(808) 378-4477
Fax
(808) 632-0077
NPI assigned
Dec 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 24009 MA
Physical Therapist 225100000X 1306228 TX
Physical Therapist 225100000X 5501018701 MI
Physical Therapist 225100000X PT-4833 HI Primary

Addresses

Primary practice location

5633 Kawaihu Road
BLDG 2a-12
Kapaa, HI 96746

Mailing address

P.O. Box 288
Lihue, HI 96766-9608
Phone (808) 632-0033

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT-4833HIMDPhysical Therapist
24009MAMDPhysical Therapist
5501018701MIMDPhysical Therapist
1306228TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaii Sports and Balance Center Physical Therapist PastSince Nov 1, 2020 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": "1544486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1154892511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 288",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967669608",
            "telephone_number": "808-632-0033",
            "fax_number": "808-632-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5633 KAWAIHU ROAD",
            "address_2": "BLDG 2A-12",
            "city": "KAPAA",
            "state": "HI",
            "postal_code": "96746",
            "telephone_number": "808-378-4477",
            "fax_number": "808-632-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "KATHERINE",
        "name_prefix": "Ms.",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-11",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "24009",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1306228",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018701",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT-4833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kapa'a, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.