Individual provider Active NPI

Katherine Elise Devick, DPT

  • Physical Therapist
  • Tallahassee, FL
National Provider Identifier
1194335778
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT36094 Issued in FL
Practice address
2410 W Plaza Dr
Tallahassee, FL 32308-5325
Phone
(850) 385-6185
Fax
(850) 385-2580
NPI assigned
Aug 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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 PT015331 GA
Physical Therapist 225100000X PT36094 FL Primary

Addresses

Primary practice location

2410 W Plaza Dr
Tallahassee, FL 32308-5325

Mailing address

PO Box 999
Moultrie, GA 31776-0999
Phone (229) 985-2080

Other practice location 1

301 S Jefferson St
Perry, FL 32347-3236
Phone (850) 584-4006

Other practice location 2

108 N Adams St
Quincy, FL 32351-2404
Phone (850) 875-0333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230821003559 FL Practitioner - Physical Therapist in Private Practice 2961864087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Orthopedic and Sports Physical Therapy P aGroup PAC ID 7810069127, 24 clinicians

Practice addresses (Care Compare)

2615 Centennial Blvd
Suite 101
Tallahasse, FL 32308-0589
Phone (850) 656-1837

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT015331GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Orthopedic and Sports Physical Therapy P a Physical Therapist CurrentSince Jul 18, 2023 Accepting new patients
Regional Therapy Services Inc PastSince Aug 9, 2020 Accepting new patients

Locations

2615 Centennial Blvd
Ste 101
Tallahassee, FL 32308

Organizations & group practices 2

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": "1596758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1194335778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 999",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317760999",
            "telephone_number": "229-985-2080",
            "fax_number": "229-890-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 W PLAZA DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085325",
            "telephone_number": "850-385-6185",
            "fax_number": "850-385-2580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 S Jefferson St",
            "address_purpose": "LOCATION",
            "city": "Perry",
            "state": "FL",
            "postal_code": "323473236",
            "country_code": "US",
            "telephone_number": "850-584-4006",
            "fax_number": "850-584-4007",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "108 N Adams St",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "FL",
            "postal_code": "323512404",
            "country_code": "US",
            "telephone_number": "850-875-0333",
            "fax_number": "850-875-0335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEVICK",
        "first_name": "KATHERINE",
        "middle_name": "ELISE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-07",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT015331",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT36094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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.