Katelyn Rose Willis, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05015264A Issued in IN

Practice address

3070 Warrick Dr
Boonville, IN 47601-9658

Phone

(812) 641-0076

Fax

(812) 641-0268

NPI assigned

Aug 7, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prorehab IncGroup PAC ID 1254317217, 81 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Prorehab Inc

  • Physical Therapist
  • Evansville, IN
  • NPI 1770565509
  Medicare reassignment Care Compare group NPD
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Indianapolis, IN
  • NPI 1336252451

  Physical Therapist

  Medicare reassignment NPD
• Tri-State Orthopaedic Surgeons, Inc.

  • Orthopaedic Surgery Physician
  • Evansville, IN
  • NPI 1073501003
  Medicare reassignment NPD
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Indianapolis, IN
  • NPI 1073622015
  NPD
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Terre Haute, IN
  • NPI 1285433953
  NPD
• Prorehab Inc

  • Durable Medical Equipment & Medical Supplies
  • Vincennes, IN
  • NPI 1841014933

  Physical Therapist

  NPD
• Tri-State Orthopaedic Surgeons, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Vincennes, IN
  • NPI 1699414961
  NPD
• Tri-State Orthopaedic Surgeons, Inc.

  • Physical Therapist
  • Evansville, IN
  • NPI 1730357237
  NPD

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

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1306528518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005",
            "telephone_number": "502-882-9379",
            "fax_number": "502-587-5728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3070 WARRICK DR",
            "city": "BOONVILLE",
            "state": "IN",
            "postal_code": "476019658",
            "telephone_number": "812-641-0076",
            "fax_number": "812-641-0268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "KATELYN",
        "middle_name": "ROSE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05015264A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Warrick Park Dental, LLP
• Samuel Watkins
• Janelle R Weatherholt, RD
• Jacqueline E Williams, MSSW LCSW
• Korbin Williams
• Wilson Family Practice, LLC
• Michelle Lynn Wilson, FNP
• Megan E Wineinger, RN
• Eric Wyant, PHARMD, RPH
• Jennifer Wyant

• Physical Therapist in Boonville, IN
• Providers in Boonville, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.