Kathryn L. Dhom, P.T.A.

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160-005465 Issued in IL

Practice address

2110 Fox Dr
Champaign, IL 61820-7553

Phone

(217) 366-1323

Fax

(217) 366-8012

NPI assigned

May 12, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Christie Clinic, PLLC

  • Internal Medicine Physician
  • Champaign, IL
  • NPI 1871523829
  NPD (past)

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305158400000",
    "number": "1447542287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W UNIVERSITY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203909",
            "telephone_number": "217-366-1200",
            "fax_number": "217-366-6106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 FOX DR",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207553",
            "telephone_number": "217-366-1323",
            "fax_number": "217-366-8012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHOM",
        "first_name": "KATHRYN",
        "middle_name": "L.",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-12",
        "last_updated": "2011-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160-005465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desired Futures Counseling & Consulting, P.L.L.C.
• Alexis Deuel, RBT
• Bryan Michael Deutsch
• Developmental Foundations, Inc.
• Developmental Services Center
• Maritza Rodriguez Diaz, LCSW
• Saron Dibissa
• Brooke Didomenico
• Samira Grace Didos, PH.D.
• Katherine Difanis

• Physical Therapy Assistant in Champaign, IL
• Providers in Champaign, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; 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.