Individual provider Active NPI

Katie Bowler

  • Physical Therapist
  • Pittsfield, MA
National Provider Identifier
1346902079
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
25815 Issued in MA
Practice address
1000 North St
Pittsfield, MA 01201-1585
Phone
(413) 642-2735
NPI assigned
Oct 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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 25815 MA Primary

Addresses

Primary practice location

1000 North St
Pittsfield, MA 01201-1585

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

25 Bridge St
Belchertown, MA 01007-8909
Phone (413) 323-1020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211026000629 MA Practitioner - Physical Therapist in Private Practice 3274921135 Reassigns benefits to 1 organization
I20230224001992 SC Practitioner - Physical Therapist in Private Practice 3274921135 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

190 River Park Dr
Little River, SC 29566-6844
Phone (843) 734-1457

491 Hwy 17
Little River, SC 29566-8082
Phone (843) 491-6422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11215SCMDPharmacist
25815MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Weston Group of South Carolina Inc Physical Therapist CurrentSince Feb 5, 2023 Accepting new patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Jan 13, 2025 Accepting new patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Jan 13, 2025 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Oct 4, 2021 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Oct 4, 2021 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

33377 Collection Ctr Dr
Chicago, IL 60693
Phone (617) 284-9418

101 University Dr
Ste A6
Amherst, MA 01002
Phone (413) 336-5703

25 Bridge St
Belchertown, MA 01007
Phone (413) 323-1020

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

872 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 347-3050

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.

NPI Registry JSON

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

{
    "created_epoch": "1633910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1346902079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 NORTH ST",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012011585",
            "telephone_number": "413-642-2735"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Bridge St",
            "address_purpose": "LOCATION",
            "city": "Belchertown",
            "state": "MA",
            "postal_code": "010078909",
            "country_code": "US",
            "telephone_number": "413-323-1020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWLER",
        "first_name": "KATIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-11",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "25815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; 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.