Katie Carroll

Individual provider Active NPI Physical Therapist · Silverdale, WA

NPI 1316622210 · NPPES record last updated Jun 19, 2023

Key facts

NPI
1316622210
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT61413269 (WA)
Practice address
2400 NW Myhre Rd Ste 102
Silverdale, WA 98383-7672
Phone
(360) 598-3764
NPI assigned
Jun 19, 2023
Sex
Female
Sole proprietor
No

Organizations & group practices 5

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.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kitsap Physical Therapy and Sports Clinic PS Inc (142 clinicians)

Practice addresses (Care Compare)

2400 NW Myhre Rd
Suite 102
Silverdale, WA 98383-7672
Phone (360) 613-1834

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230721002592 WA Practitioner - Physical Therapist in Private Practice 2062872021 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PT61413269WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kitsap Physical Therapy and Sports Clinic PS Inc Physical Therapist Current
since Jul 3, 2023
Accepting new patients
Kitsap Physical Therapy and Sports Clinic PS Inc Physical Therapist Current
since Jul 3, 2023
Accepting new patients

Locations

2400 NW Myhre Rd
Ste 101
Silverdale, WA 98383
Phone (360) 598-3764

2400 NW Myhre Rd
Ste 102
Silverdale, WA 98383
Phone (360) 598-3764

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT61413269 WA Yes

Addresses

Primary practice location

2400 NW Myhre Rd Ste 102
Silverdale, WA 98383-7672

Mailing address

2400 NW Myhre Rd Ste 101
Silverdale, WA 98383-7672
Phone (360) 598-3764

Other providers in Silverdale, WA

All providers in Silverdale, WA · Physical Therapist in Washington

Sources for this page

Verify at the official NPI Registry.