Individual provider Active NPI

Katelynn Clare Paulsen, PT, DPT

  • Physical Therapist
  • Pueblo, CO
National Provider Identifier
1245847243
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0017212 Issued in CO
Practice address
1301 Fortino Blvd
Pueblo, CO 81008-2032
Phone
(719) 696-7799
NPI assigned
Sep 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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 0017212 CO Primary

Addresses

Primary practice location

1301 Fortino Blvd
Pueblo, CO 81008-2032

Mailing address

1301 Fortino Blvd
Pueblo, CO 81008-2032
Phone (724) 766-2421

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
0017212COMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1245847243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 FORTINO BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082032",
            "telephone_number": "724-766-2421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 FORTINO BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082032",
            "telephone_number": "719-696-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULSEN",
        "first_name": "KATELYNN",
        "middle_name": "CLARE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-24",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0017212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.