Individual provider Active NPI

Kaitlin Hong, DPT, ATC/L

  • Physical Therapist
  • Milwaukee, WI
National Provider Identifier
1255729901
Registry record updated Jan 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11877 Issued in WI
Practice address
3365 S 103Rd St Ste 150
Milwaukee, WI 53227-4161
Phone
(414) 607-5280
NPI assigned
Jan 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X 11877 WI
Athletic Trainer 2255A2300X 1222 WI
Physical Therapist 225100000X 11877 WI Primary

Addresses

Primary practice location

3365 S 103Rd St Ste 150
Milwaukee, WI 53227-4161

Mailing address

3365 S 103Rd St Ste 150
Milwaukee, WI 53227-4161

Other practice location 1

7137 236th Ave Ste 101
Salem, WI 53168-8975
Phone (262) 925-5060

Other practice location 2

10222 74th St Ste 211
Kenosha, WI 53142-6810
Phone (262) 925-5020

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1222WIMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital of Wisconsin, Inc. PastSince Feb 2, 2020 Accepting new patients

Organizations & group practices 1

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": "1420416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579910400000",
    "number": "1255729901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3365 S 103RD ST STE 150",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532274161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3365 S 103RD ST STE 150",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532274161",
            "telephone_number": "414-607-5280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7137 236th Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "WI",
            "postal_code": "531688975",
            "country_code": "US",
            "telephone_number": "262-925-5060",
            "fax_number": "262-925-5061",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10222 74th St Ste 211",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531426810",
            "country_code": "US",
            "telephone_number": "262-925-5020",
            "fax_number": "262-925-5021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HONG",
        "first_name": "KAITLIN",
        "credential": "DPT, ATC/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-05",
        "last_updated": "2020-01-25",
        "certification_date": "2020-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "WI",
            "license": "11877",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "1222",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "11877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2020; 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.