Kaden Ray Hersel

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT61599533 Issued in WA

Practice address

1100 Vista PL Apt Q
Wenatchee, WA 98801-4206

Phone

(509) 741-7283

NPI assigned

Jul 28, 2019

Last updated

Dec 5, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pro Sport Physical Therapy, LLCGroup PAC ID 9436573177, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pro Sport Physical Therapy, LLC

  • Physical Therapist
  • Gig Harbor, WA
  • NPI 1114552155
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1564272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1467006544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 NE WESTWOOD DR APT D",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635384",
            "telephone_number": "509-741-7283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 VISTA PL APT Q",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988014206",
            "telephone_number": "509-741-7283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSEL",
        "first_name": "KADEN",
        "middle_name": "RAY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-28",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61599533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura J Herrera, LMP NCTMB
• Melissa R Herrick, CG, CO
• Allison Kay Herrington, P.T.
• Rori Natasha Herscher-Fletcher, D.O.
• Jamie Lynn Hersel, RN
• Mikiala Hersel, SUDPT
• Kirsten Grace Herzer, MSN
• Richard A Hesner, PT
• Darren Michael Hess, MD, PHD
• Caitlin Hickok, DPT

• Physical Therapist in Wenatchee, WA
• Providers in Wenatchee, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.