Individual provider Active NPI

Kelsey Kata, PT, DPT

  • Physical Therapist
  • Columbia, SC
National Provider Identifier
1356606578
Registry record updated Nov 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6781 Issued in SC
Practice address
115 Atrium Way
Suite 232
Columbia, SC 29223-6371
Phone
(803) 788-8499
Fax
(803) 788-8499
NPI assigned
Jul 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2017

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 6781 SC Primary

Addresses

Primary practice location

115 Atrium Way
Suite 232
Columbia, SC 29223-6371

Mailing address

3210 Millwood Ave Apt B
Columbia, SC 29205-1827
Phone (616) 581-7963

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120831000514 SC Practitioner - Physical Therapist in Private Practice 2961659669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

141 Atrium Way
Columbia, SC 29223-6301
Phone (803) 788-8484

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6781SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Physical Therapy and Sports Medicine Limited Partnership Physical Therapist CurrentSince Jul 1, 2017 Accepting new patients
Carolina Physical Therapy and Sports Medicine, Inc. Past Accepting new patients

Locations

141 Atrium Way
Columbia, SC 29223
Phone (803) 788-8484

863 Coleman Blvd
Ste B
Mt Pleasant, SC 29464
Phone (843) 881-8887

Organizations & group practices 2

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": "1342137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510704000000",
    "number": "1356606578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 MILLWOOD AVE APT B",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292051827",
            "telephone_number": "616-581-7963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 ATRIUM WAY",
            "address_2": "SUITE 232",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236371",
            "telephone_number": "803-788-8499",
            "fax_number": "803-788-8499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATA",
        "first_name": "KELSEY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-13",
        "last_updated": "2017-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "6781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2017; 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.