Active NPI
Katharine Prudhomme
- Physical Therapy Assistant
- Scottsdale, AZ
National Provider Identifier
1659789287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 11007A
- Practice address
- 2623 N 81St Way
Scottsdale, AZ 85257-1710 - Phone
- (847) 875-2260
- NPI assigned
- Jul 28, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 11007A | AZ | Primary |
Addresses
Primary practice location
2623 N 81St Way
Scottsdale, AZ 85257-1710
Mailing address
2623 N 81St Way
Scottsdale, AZ 85257-1710
Phone (847) 875-2260
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11007A | AZ | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406505600000",
"number": "1659789287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2623 N 81ST WAY",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852571710",
"telephone_number": "847-875-2260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2623 N 81ST WAY",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852571710",
"telephone_number": "847-875-2260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRUDHOMME",
"first_name": "KATHARINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-28",
"last_updated": "2014-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AZ",
"license": "11007A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.