Individual provider Active NPI

Kathryn Dove

  • Physical Therapist
  • Bellevue, WA
National Provider Identifier
1366842973
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60469535 Issued in WA
Practice address
1035 116TH Ave NE
Bellevue, WA 98004-4604
Phone
(425) 467-3655
NPI assigned
Sep 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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 PT60469535 WA Primary

Addresses

Primary practice location

1035 116TH Ave NE
Bellevue, WA 98004-4604

Mailing address

1035 116TH Ave NE
Bellevue, WA 98004-4604

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141231002125 WA Practitioner - Physical Therapist in Private Practice 6800119603 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Overlake Medical Clinics LLCGroup PAC ID 7012808827, 423 clinicians

Practice addresses (Care Compare)

1740 NW Maple St
Issaquah, WA 98027-8127

1750 112TH Ave NE
Suite B102
Bellevue, WA 98004-3772
Phone (425) 688-5460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Overlake Medical Clinics, LLC Current Accepting new patients
Overlake Medical Clinics LLC CurrentSince Apr 24, 2023 Accepting new patients
The Polyclinic PLLC CurrentSince Apr 10, 2017 Accepting new patients
The Polyclinic PLLC Current Accepting new patients
The Polyclinic CurrentSince Apr 10, 2017 Accepting new patients

Locations

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

1740 NW Maple St
Ste 111
Issaquah, WA 98027
Phone (425) 394-1200

904 7th Ave
Seattle, WA 98104
Phone (206) 223-6487

1145 Broadway
Seattle, WA 98122

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": "1409616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1366842973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 116TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 116TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044604",
            "telephone_number": "425-467-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOVE",
        "first_name": "KATHRYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-02",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60469535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; 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.