Individual provider Active NPI

Katherine S Rose

  • Physical Therapist
  • Marquette, MI
National Provider Identifier
1518099746
Registry record updated Jan 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501004677 Issued in MI
Practice address
1025 W Washington St
Marquette, MI 49855-4035
Phone
(906) 869-2776
NPI assigned
Mar 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501004677 MI Primary

Addresses

Primary practice location

1025 W Washington St
Marquette, MI 49855-4035

Mailing address

1068 Ortman Rd
Marquette, MI 49855-9332
Phone (906) 249-9498

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501004677MIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389312000000",
    "number": "1518099746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1068 ORTMAN RD",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498559332",
            "telephone_number": "906-249-9498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 W WASHINGTON ST",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554035",
            "telephone_number": "906-869-2776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "KATHERINE",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2014-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501004677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.