Individual provider Active NPI

Kaitlin Correale

  • Physical Therapy Assistant
  • Weatherly, PA
National Provider Identifier
1245640762
Registry record updated May 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
TEI003885 Issued in PA
Practice address
902 Hudson Dr
Weatherly, PA 18255
Phone
(570) 578-8205
NPI assigned
May 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X TEI003885 PA Primary

Addresses

Primary practice location

902 Hudson Dr
Weatherly, PA 18255

Mailing address

902 Hudson Dr
Weatherly, PA 18255-2818

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
TEI003885PAMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1399334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399334400000",
    "number": "1245640762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 HUDSON DR",
            "city": "WEATHERLY",
            "state": "PA",
            "postal_code": "182552818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 HUDSON DR",
            "city": "WEATHERLY",
            "state": "PA",
            "postal_code": "18255",
            "telephone_number": "570-578-8205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORREALE",
        "first_name": "KAITLIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-06",
        "last_updated": "2014-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TEI003885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weatherly, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; 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.