Individual provider Active NPI

Kathleen Kober, PT

  • Physical Therapist
  • Frederick, MD
National Provider Identifier
1417282716
Registry record updated Feb 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
23078 Issued in MD
Practice address
187 Thomas Johnson Dr
Suite 6
Frederick, MD 21702-4503
Phone
(301) 663-1157
Fax
(301) 663-1229
NPI assigned
Oct 5, 2009
Last updated
Feb 24, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2012

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 23078 MD Primary

Addresses

Primary practice location

187 Thomas Johnson Dr
Suite 6
Frederick, MD 21702-4503

Mailing address

187 Thomas Johnson Dr
Suite 6
Frederick, MD 21702-4503
Phone (301) 663-1157

Other names 1

  • Kathleen Childs Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120207000423 DC Practitioner - Physical Therapist in Private Practice 9234303108 Reassigns benefits to 1 organization
I20221102000655 MD Practitioner - Physical Therapist in Private Practice 9234303108 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Amber Hill Physical Therapy, Inc. Physical Therapist CurrentSince Oct 7, 2011 Accepting new patients

Locations

9701 New Church St
Ste 3
Damascus, MD 20872
Phone (301) 253-0896

187 Thomas Johnson Dr
Frederick, MD 21702
Phone (301) 378-9421

187 Thomas Johnson Dr
Ste 6
Frederick, MD 21702
Phone (301) 663-1157

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1254700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330041600000",
    "number": "1417282716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 THOMAS JOHNSON DR",
            "address_2": "SUITE 6",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024503",
            "telephone_number": "301-663-1157",
            "fax_number": "301-663-1229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 THOMAS JOHNSON DR",
            "address_2": "SUITE 6",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024503",
            "telephone_number": "301-663-1157",
            "fax_number": "301-663-1229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBER",
        "first_name": "KATHLEEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-05",
        "last_updated": "2012-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "23078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "CHILDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.