Katrina Renee Iseman, DPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

199540 Issued in AK

Practice address

12812 Old Glenn Hwy Ste A3
Eagle River, AK 99577-7003

Phone

(907) 795-8115

NPI assigned

Jul 2, 2018

Last updated

Oct 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Katrina Renee Pilch Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Spokane Guilds' School & Neuromuscular Center

  • Developmental Disabilities Clinic/Center
  • Spokane, WA
  • NPI 1063493393
  NPD (past)

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1609362664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11201 E GROW LN",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996458881",
            "telephone_number": "907-841-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12812 OLD GLENN HWY STE A3",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777003",
            "telephone_number": "907-795-8115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2118 W Garland Ave",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992052526",
            "country_code": "US",
            "telephone_number": "509-326-1651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISEMAN",
        "first_name": "KATRINA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-02",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "WA",
            "license": "PT60828525",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "AK",
            "license": "199540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATRINA",
            "last_name": "PILCH",
            "middle_name": "RENEE",
            "prefix": "MISS",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Clinton O Jackson
• Dagmar Jackson

• Pediatric Physical Therapist in Eagle River, AK
• Providers in Eagle River, AK by specialty
• Pediatric Physical Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; 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.