Individual provider Active NPI

Katelin Anderson, DPT

  • Physical Therapist
  • Sartell, MN
National Provider Identifier
1174867907
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9200 Issued in MN
Practice address
2251 Connecticut Ave S Ste 3600
Sartell, MN 56377-2556
Phone
(320) 529-0036
NPI assigned
Nov 16, 2012
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
070.019564ILMDPhysical Therapist
9200MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alpha Rehabilitation Medical Center LTD Past
since Nov 15, 2016
Accepting new patients

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.019564 IL
Physical Therapist 225100000X 9200 MN Primary

Addresses

NPPES NPI Registry

Primary practice location

2251 Connecticut Ave S Ste 3600
Sartell, MN 56377-2556

Mailing address

2251 Connecticut Ave S Ste 3600
Sartell, MN 56377-2556

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 3, 2019.

{
    "created_epoch": "1353024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1174867907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2251 CONNECTICUT AVE S STE 3600",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2251 CONNECTICUT AVE S STE 3600",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772556",
            "telephone_number": "320-529-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KATELIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-16",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.019564",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "9200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sartell, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; 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.