Individual provider Active NPI

Katherine Kipouras, P.T.

  • Physical Therapist
  • Salem, NH
National Provider Identifier
1578658324
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5275 Issued in MA
Practice address
70 Butler Street
Salem, NH 03079
Phone
(603) 893-2900
Fax
(603) 893-1628
NPI assigned
Oct 4, 2006
Last updated
Oct 7, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

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 5275 MA Primary
Physical Therapist 225100000X PT25401 CA

Addresses

Primary practice location

70 Butler Street
Salem, NH 03079

Mailing address

70 Butler Street
Salem, NH 03079
Phone (603) 893-2900

Other identifiers 2

IdentifierTypeStateIssuer
Y66507OtherMABLUE CROSS PROVIDER ID
468801OtherMATUFTS PROVIDER ID

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
PT25401CAMDPhysical Therapist
5275MAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Edge PT, Inc. PastSince May 17, 2020 Accepting new patients
Personal Edge Physical Therapy, Inc. Physical Therapist PastSince Mar 31, 2008 Accepting new patients

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, 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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444176000000",
    "number": "1578658324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 BUTLER STREET",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "03079",
            "telephone_number": "603-893-2900",
            "fax_number": "603-893-1628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 BUTLER STREET",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "03079",
            "telephone_number": "603-893-2900",
            "fax_number": "603-893-1628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIPOURAS",
        "first_name": "KATHERINE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2015-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "5275",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT25401",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER ID",
            "identifier": "Y66507",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS PROVIDER ID",
            "identifier": "468801",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; 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.