Individual provider Active NPI

Caitlin McDonald

  • Physical Therapist
  • Scenery Hill, PA
National Provider Identifier
1568146017
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
MP990017 Issued in NC
Practice address
100 Wonsettler Rd
Scenery Hill, PA 15360-1863
Phone
(724) 945-5161
NPI assigned
Jun 14, 2023
Last updated
Sep 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X 721807 PA
Physical Therapist 225100000X MP990017 NC Primary

Addresses

Primary practice location

100 Wonsettler Rd
Scenery Hill, PA 15360-1863

Mailing address

100 Wonsettler Rd
Scenery Hill, PA 15360-1863
Phone (724) 945-5161

Other practice location 1

292 Commerce Ave
Southern Pines, NC 28387-7059
Phone (910) 757-0408

Other names 1

  • Caitlin Clarke Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230718002834 PA Practitioner - Physical Therapist in Private Practice 9234599507 Reassigns benefits to 1 organization
I20241119002388 NC Practitioner - Physical Therapist in Private Practice 9234599507 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
721807PAMDPhysical Medicine & Rehabilitation Physician
MP990017NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Performance Sports and Physical Therapy, LLC Multi-Specialty CurrentSince Oct 27, 2024 Accepting new patients
Wonsettler Physical Therapy and Specialized Health Multi-Specialty CurrentSince Jun 14, 2023 Accepting new patients
Carolina Strong Physical Therapy, LLC Physical Therapist CurrentSince Sep 3, 2024 Accepting new patients

Locations

2009 Neuse Blvd
New Bern, NC 28560
Phone (252) 636-9800

292 Commerce Ave
Southern Pnes, NC 28387
Phone (910) 757-0408

4002 Executive Park Blvd
Ste 800
Southport, NC 28461
Phone (910) 357-5748

100 Wonsettler Rd
Scenery Hill, PA 15360
Phone (724) 200-7377

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1568146017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WONSETTLER RD",
            "city": "SCENERY HILL",
            "state": "PA",
            "postal_code": "153601863",
            "telephone_number": "724-945-5161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WONSETTLER RD",
            "city": "SCENERY HILL",
            "state": "PA",
            "postal_code": "153601863",
            "telephone_number": "724-945-5161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "292 Commerce Ave",
            "address_purpose": "LOCATION",
            "city": "Southern Pines",
            "state": "NC",
            "postal_code": "283877059",
            "country_code": "US",
            "telephone_number": "910-757-0408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "CAITLIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-14",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "721807",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "MP990017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAITLIN",
            "last_name": "CLARKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Scenery Hill, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.