Katieanne P Christian, DPT
Individual provider Active NPI Physical Therapist · Mystic, CT
NPI 1194064147 · NPPES record last updated Feb 12, 2013
Key facts
- NPI
- 1194064147
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 009224 (CT)
- Practice address
- 2440 Gold Star Hwy
Suite 201
Mystic, CT 06355-1180 - Phone
- (860) 536-1001
- Fax
- (860) 536-1005
- NPI assigned
- Feb 12, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Independence Physical Therapy, LLC
Practice addresses (Care Compare)
2440 Gold Star Hwy
Mystic, CT 06355-1180
2440 Gold Star Hwy 201
Mystic, CT 06355-1180
Phone (860) 536-1001
2440 Goldstar Hwy
Suite 201
Mystic, CT 06355-1180
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130816000160 | CT | Practitioner - Physical Therapist in Private Practice | 4587806880 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009224 | CT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Norwich Orthopedic Group, P.C. | Current |
Accepting new patients | |
| Independence Physical Therapy, LLC | Physical Therapist | Current |
Accepting new patients |
| Norwich Orthopedic Group, P.C. | Physical Therapist | Current |
Accepting new patients |
Locations
11 Industrial Park Rd
Niantic, CT 06357
Phone (860) 391-9397
82 New Park Ave
North Franklin, CT 06254
Phone (860) 889-7345
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 009224 | CT | Yes |
Addresses
Primary practice location
2440 Gold Star Hwy
Suite 201
Mystic, CT 06355-1180
Mailing address
2440 Gold Star Hwy
Suite 201
Mystic, CT 06355
Phone (860) 536-1001
Other providers in Mystic, CT
- Child and Family Agency of Southeastern Connecticut Inc.
- Child and Family Agency of Southeastern Connecticut, Inc.
- Child and Family Agency of Southeastern Connecticut, Inc.
- Child and Family Agency of Southeastern Connecticut, Inc.
- Sungsil Cho
- Christopher Level Inc
- Kathrine Lynn Clarke
- Jeannine Cleaver
- Coastal Chiropractic & Family Wellness Centre
- Coastal Dermatology, P.C.
All providers in Mystic, CT · Physical Therapist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.