Individual provider Active NPI

Katelyn Elizabeth Grue, DPT

  • Physical Therapist
  • Columbia, MD
National Provider Identifier
1588035992
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
25710 Issued in MD
Practice address
10700 Charter Dr Ste 100
Columbia, MD 21044-3631
Phone
(410) 992-7800
Fax
(410) 720-2190
NPI assigned
Oct 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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 25710 MD Primary

Addresses

Primary practice location

10700 Charter Dr Ste 100
Columbia, MD 21044-3631

Mailing address

10700 Charter Dr Ste 100
Columbia, MD 21044-3631
Phone (410) 992-7800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151105000846 DC Practitioner - Physical Therapist in Private Practice 5395055214 Reassigns benefits to 2 organizations
I20160208000271 MD Practitioner - Physical Therapist in Private Practice 5395055214 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centers for Advanced Orthopaedics LLCGroup PAC ID 8123260981, 599 clinicians
Maryland Sportscare and Rehab LLCGroup PAC ID 2860440427, 166 clinicians

Practice addresses (Care Compare)

10700 Charter Dr
Suite 100
Columbia, MD 21044-3631
Phone (410) 992-7800

757 Frederick Rd
Suite 103
Catonsville, MD 21228-4520
Phone (410) 719-8661

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Centers for Advanced Orthopaedics, LLC Physical Therapist Current Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Apr 22, 2024 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Apr 22, 2024 Accepting new patients
Life Fitness Physical Therapy LLC Physical Therapist Past Accepting new patients

Locations

10700 Charter Dr
Ste 100
Columbia, MD 21044
Phone (301) 774-0500

10710 Charter Dr
Ste 300
Columbia, MD 21044
Phone 4106441880450

3414 Olandwood Ct
Olney, MD 20832
Phone (301) 774-0500

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1588035992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 CHARTER DR STE 100",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443631",
            "telephone_number": "410-992-7800",
            "fax_number": "410-720-2190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 CHARTER DR STE 100",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443631",
            "telephone_number": "410-992-7800",
            "fax_number": "410-720-2190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUE",
        "first_name": "KATELYN",
        "middle_name": "ELIZABETH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-12",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "25710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.