Active NPI
Katherine O'Donnell, D.P.T.
- Physical Therapist
- Kapa'a, HI
National Provider Identifier
1154892511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-4833
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| PT-4833 | HI | MD | Physical Therapist |
| 24009 | MA | MD | Physical Therapist |
| 5501018701 | MI | MD | Physical Therapist |
| 1306228 | TX | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hawaii Sports and Balance Center | Physical Therapist | Past | 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.
-
- Physical Therapist
- Lihue, HI
- NPI 1639333180
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.