Active NPI
Shraddha Kadam, PHYSICAL THERAPIST
- Physical Therapist
- Denison, TX
National Provider Identifier
1487134748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1269197
- Practice address
- 1101 Reba Macentire LN
Denison, TX 75020-9059 - Phone
- (903) 463-4663
- NPI assigned
- Aug 16, 2018
- Last updated
- Aug 16, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1269197 | TX | Primary |
Addresses
Primary practice location
1101 Reba Macentire LN
Denison, TX 75020-9059
Mailing address
211 E Canyon Grove Rd Apt 534
Knollwood, TX 75092-3942
Phone (908) 528-4945
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1269197 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534377600000",
"number": "1487134748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 E CANYON GROVE RD APT 534",
"city": "KNOLLWOOD",
"state": "TX",
"postal_code": "750923942",
"telephone_number": "908-528-4945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 REBA MACENTIRE LN",
"city": "DENISON",
"state": "TX",
"postal_code": "750209059",
"telephone_number": "903-463-4663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KADAM",
"first_name": "SHRADDHA",
"name_prefix": "Miss",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-16",
"last_updated": "2018-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1269197",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denison, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.