Individual provider Active NPI

Kaitlin Christine Emrey, PHYSICAL THERAPIST

  • Physical Therapist
  • Lewes, DE
National Provider Identifier
1467083782
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
J1-0004171 Issued in DE
Practice address
12100 Black Swan Drive
Suite 202
Lewes, DE 19958
Phone
(302) 644-5591
Fax
(302) 449-2047
NPI assigned
Jan 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X J1-0004171 DE Primary

Addresses

Primary practice location

12100 Black Swan Drive
Suite 202
Lewes, DE 19958

Mailing address

12100 Black Swan Drive
Suite 202
Lewes, DE 19958
Phone (302) 644-5591

Other names 1

  • Kaitlin Christine Davis Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200226001555 DE Practitioner - Physical Therapist in Private Practice 9032546312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

20268 Plantations Rd B
Lewes, DE 19958-4622
Phone (302) 727-0075

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
J1-0004171DEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Physical Therapy and Sports Performance Limited Partnership CurrentSince Feb 3, 2020 Accepting new patients
Premier Physical Therapy and Sports Performance Limited Partnership Physical Therapist CurrentSince Feb 3, 2020 Accepting new patients

Locations

20268 Plantations Rd
Ste B
Lewes, DE 19958
Phone (302) 449-2048

12100 Black Swan Dr
Ste 202
Lewes, DE 19958
Phone (302) 449-6476

1050 Industrial Dr
Ste 210
Middletown, DE 19709

100 S Main St
Ste 300
Smyrna, DE 19977
Phone (302) 389-7855

Organizations & group practices 2

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": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1467083782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12100 BLACK SWAN DRIVE",
            "address_2": "SUITE 202",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "19958",
            "telephone_number": "302-644-5591",
            "fax_number": "302-449-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 BLACK SWAN DRIVE",
            "address_2": "SUITE 202",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "19958",
            "telephone_number": "302-644-5591",
            "fax_number": "302-449-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMREY",
        "first_name": "KAITLIN",
        "middle_name": "CHRISTINE",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-27",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J1-0004171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLIN",
            "last_name": "DAVIS",
            "middle_name": "CHRISTINE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lewes, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; 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.