Individual provider Active NPI

Katelyn Nicole Combs, DPT

  • Physical Therapist
  • Carrollton, TX
National Provider Identifier
1205337789
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1343285 Issued in TX
Practice address
1000 W Crosby Rd Ste 136
Carrollton, TX 75006-6904
Phone
(972) 237-0100
NPI assigned
Feb 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Student in an Organized Health Care Education/Training Program 390200000X
Physical Therapist 225100000X 1343285 TX Primary

Addresses

Primary practice location

1000 W Crosby Rd Ste 136
Carrollton, TX 75006-6904

Mailing address

3242 Village Park Dr
Waco, TX 76708-1582
Phone (606) 622-3536

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231031000036 TX Practitioner - Physical Therapist in Private Practice 7517313364 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
CKC Holdings LLC CurrentSince Feb 27, 2022 Accepting new patients
CKC Holdings LLC CurrentSince Mar 24, 2024 Accepting new patients
Kids Therapy Specialties LLC Physical Therapist CurrentSince Oct 16, 2023 Accepting new patients

Locations

1000 W Crosby Rd
Ste 136
Carrollton, TX 75006
Phone (972) 237-0100

4900 Sanger Ave
Waco, TX 76710
Phone (254) 644-2423

Organizations & group practices 3

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": "1519171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1205337789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3242 VILLAGE PARK DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767081582",
            "telephone_number": "606-622-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W CROSBY RD STE 136",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750066904",
            "telephone_number": "972-237-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMBS",
        "first_name": "KATELYN",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-21",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1343285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.