Individual provider Active NPI

Kathleen Mary Collette, PT

  • Physical Therapist
  • Sanford, ME
National Provider Identifier
1407415425
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT1371 Issued in ME
Practice address
13 July St
Sanford, ME 04073-1909
Phone
(207) 490-7098
NPI assigned
Jun 12, 2019
Last updated
Jun 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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 PT1371 ME Primary

Addresses

Primary practice location

13 July St
Sanford, ME 04073-1909

Mailing address

60 Cooks Brook Dr
Dayton, ME 04005-7025
Phone (207) 841-9572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT1371MEMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1407415425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 COOKS BROOK DR",
            "city": "DAYTON",
            "state": "ME",
            "postal_code": "040057025",
            "telephone_number": "207-841-9572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 JULY ST",
            "city": "SANFORD",
            "state": "ME",
            "postal_code": "040731909",
            "telephone_number": "207-490-7098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLETTE",
        "first_name": "KATHLEEN",
        "middle_name": "MARY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT1371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.