Individual provider Active NPI

Katie Larkin, PT

  • Physical Therapist
  • Black River Falls, WI
National Provider Identifier
1457534554
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10935-24 Issued in WI
Practice address
711 W Adams St
Black River Falls, WI 54615-9108
Phone
(715) 284-5361
Fax
(715) 284-1398
NPI assigned
Dec 11, 2007
Last updated
Dec 11, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

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 10935-24 WI Primary

Addresses

Primary practice location

711 W Adams St
Black River Falls, WI 54615-9108

Mailing address

711 W Adams St
Black River Falls, WI 54615-9108
Phone (715) 284-5361

Other identifiers 1

IdentifierTypeStateIssuer
10935-24OtherWIWISCONSIN STATE LICENSE

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
10935-24WIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1457534554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 W ADAMS ST",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546159108",
            "telephone_number": "715-284-5361",
            "fax_number": "715-284-1398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 W ADAMS ST",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546159108",
            "telephone_number": "715-284-5361",
            "fax_number": "715-284-1398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARKIN",
        "first_name": "KATIE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-11",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "10935-24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN STATE LICENSE",
            "identifier": "10935-24",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Black River Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; 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.