Individual provider Active NPI

Katelyn Kush, DPT

  • Physical Therapist
  • Granger, IN
National Provider Identifier
1194349555
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05013618A Issued in IN
Practice address
3221 Beacon Pkwy Ste 100
Granger, IN 46530-7196
Phone
(574) 647-2930
NPI assigned
Jun 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05013618A IN Primary

Addresses

Primary practice location

3221 Beacon Pkwy Ste 100
Granger, IN 46530-7196

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380
Phone (574) 647-2129

Other practice location 1

200 E Jackson Blvd Ste 150
Elkhart, IN 46516-3513
Phone (574) 389-5558

Other practice location 2

2222 Rieth Blvd Ste 103
Goshen, IN 46526-5869
Phone (574) 875-9616

Other practice location 3

900 I St Ste 100
LA Porte, IN 46350-5533
Phone (219) 324-1730

Other practice location 4

1815 E Ireland Rd Ste 100
South Bend, IN 46614-2845
Phone (574) 647-5790

Other identifiers 1

IdentifierTypeStateIssuer
300039529MedicaidIN

Other names 1

  • Katelyn Harvey Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address keharvey@mybeacon.cernerdirect.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200713001031 IN Practitioner - Physical Therapist in Private Practice 0244653004 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beacon Health LLCGroup PAC ID 1254690530, 32 clinicians

Practice addresses (Care Compare)

3221 Beacon Pkwy
Suite 100
Granger, IN 46530-7196
Phone (574) 647-2930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince May 1, 2023 Accepting new patients
Creative Health Care Management LLC Physical Therapist CurrentSince Jun 1, 2023 Accepting new patients
Creative Health Care Management LLC Physical Therapist CurrentSince Jun 1, 2023 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince May 1, 2023 Accepting new patients
Beacon Health, LLC Past Accepting new patients
Beacon Medical Group, Inc. PastSince Jul 23, 2020 Accepting new patients

Locations

11570 E 126th St
Fishers, IN 46037
Phone (317) 349-5913

300 E Washington Blvd
Fort Wayne, IN 46802
Phone (260) 422-5511

1540 S Logan St
Mishawaka, IN 46544
Phone (574) 207-0833

3630 Hickory Rd
Mishawaka, IN 46545
Phone (574) 252-7225

10 S 9th St
Ste 4
Noblesville, IN 46060

Organizations & group practices 7

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": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1194349555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380",
            "telephone_number": "574-647-2129",
            "fax_number": "574-237-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3221 BEACON PKWY STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465307196",
            "telephone_number": "574-647-2930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 E Jackson Blvd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465163513",
            "country_code": "US",
            "telephone_number": "574-389-5558",
            "fax_number": "574-389-5559",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2222 Rieth Blvd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "IN",
            "postal_code": "465265869",
            "country_code": "US",
            "telephone_number": "574-875-9616",
            "fax_number": "574-875-9817",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 I St Ste 100",
            "address_purpose": "LOCATION",
            "city": "LA Porte",
            "state": "IN",
            "postal_code": "463505533",
            "country_code": "US",
            "telephone_number": "219-324-1730",
            "fax_number": "219-324-1735",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1815 E Ireland Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466142845",
            "country_code": "US",
            "telephone_number": "574-647-5790",
            "fax_number": "574-647-5792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUSH",
        "first_name": "KATELYN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-02",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05013618A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300039529",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "keharvey@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "3221 Beacon Pkwy Ste 100",
            "city": "Granger",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465307196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "HARVEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Granger, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; 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.