Individual provider Active NPI

Katelyn Rose McFaddin Dean, DPT

  • Physical Therapist
  • Winston Salem, NC
National Provider Identifier
1457927030
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP024709T Issued in NC
Practice address
170 Kimel Park Dr
Winston Salem, NC 27103-6946
Phone
(336) 765-7058
NPI assigned
Jun 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 10701 SC
Physical Therapist 225100000X 13637 TN
Physical Therapist 225100000X CP024709T NC Primary

Addresses

Primary practice location

170 Kimel Park Dr
Winston Salem, NC 27103-6946

Mailing address

PO Box 601791
Charlotte, NC 28260-1791
Phone (336) 765-7058

Other practice location 1

311 Congress Pkwy N Ste 800
Athens, TN 37303-1697
Phone (423) 744-0890

Other practice location 2

3386 Yampa St
Sumter, SC 29150-2045
Phone (803) 233-4505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210625002508 TN Practitioner - Physical Therapist in Private Practice 9032510193 Reassigns benefits to 2 organizations
I20250527002064 SC Practitioner - Physical Therapist in Private Practice 9032510193 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP024709TNCMDPhysical Therapist
13637TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Agilitas USA Inc CurrentSince Dec 5, 2022 Accepting new patients
Drayer Physical Therapy-South Carolina, LLC Physical Therapist CurrentSince Apr 22, 2025 Accepting new patients
Drayer Physical Therapy - South Carolina, LLC Physical Therapist CurrentSince Apr 22, 2025 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Dec 5, 2022 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Apr 22, 2025 Accepting new patients
Benchmark Healthcare Services, LLC Physical Therapist CurrentSince Apr 22, 2025 Accepting new patients
Independent Physical Therapy, LLC Physical Therapist CurrentSince Jun 7, 2021 Accepting new patients
Benchmark Health Services Physical Therapist CurrentSince Apr 22, 2025 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

135 Blythewood Rd
#J
Blythewood, SC 29016
Phone (803) 851-1037

1000 Tanner Ford Blvd
Ste 370
Hanahan, SC 29410
Phone (843) 718-1058

7585 Saint Andrews Rd
Irmo, SC 29063
Phone (803) 749-5031

3032 W Montague Ave
Ste 101
North Charleston, SC 29418
Phone (843) 885-8772

1672 N Main St
Ste 11
Summerville, SC 29486
Phone (843) 289-1456

3386 Yampa St
Sumter, SC 29150
Phone (803) 233-4505

311 Congress Pkwy N
Ste 800
Athens, TN 37303
Phone (423) 744-0890

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

1202 N Charles G Seivers Blvd
Ste A
Clinton, TN 37716
Phone (865) 457-0192

3493 Veterans Dr N
Ste D
Huntingdon, TN 38344
Phone (731) 209-4444

5220 Park Ave
Ste 201
Memphis, TN 38119
Phone (901) 683-9630

Organizations & group practices 8

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": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1457927030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601791",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601791",
            "telephone_number": "336-765-7058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 KIMEL PARK DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036946",
            "telephone_number": "336-765-7058"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "311 Congress Pkwy N Ste 800",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "TN",
            "postal_code": "373031697",
            "country_code": "US",
            "telephone_number": "423-744-0890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3386 Yampa St",
            "address_purpose": "LOCATION",
            "city": "Sumter",
            "state": "SC",
            "postal_code": "291502045",
            "country_code": "US",
            "telephone_number": "803-233-4505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEAN",
        "first_name": "KATELYN",
        "middle_name": "ROSE MCFADDIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-03",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "10701",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "13637",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "CP024709T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.