Katherine Dodge, P.T.
Individual provider Active NPI Physical Therapist · Kittery, ME
NPI 1467645192 · NPPES record last updated Aug 27, 2007
Key facts
- NPI
- 1467645192
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT2648 (ME)
- Practice address
- 22 Shapleigh Rd
Kittery, ME 03904-1455 - Phone
- (207) 439-8939
- NPI assigned
- Aug 27, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240429000125 | ME | Practitioner - Physical Therapist in Private Practice | 5991145658 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT2648 | ME | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT2648 | ME | Yes |
Addresses
Primary practice location
22 Shapleigh Rd
Kittery, ME 03904-1455
Mailing address
22 Shapleigh Rd
Kittery, ME 03904-1455
Phone (207) 439-8939
Other providers in Kittery, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 27, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.