Individual provider Active NPI

Katlin Cornelius

  • Physical Therapist
  • Beaver Dam, KY
National Provider Identifier
1659926657
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
007725 Issued in KY
Practice address
227 S Main St
Beaver Dam, KY 42320-2131
Phone
(270) 274-9221
Fax
(270) 955-2003
NPI assigned
Aug 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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 007725 KY Primary

Addresses

Primary practice location

227 S Main St
Beaver Dam, KY 42320-2131

Mailing address

227 S Main St
Beaver Dam, KY 42320-2131
Phone (270) 274-9221

Other identifiers 1

IdentifierTypeStateIssuer
007725OtherKYPT LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231204003145 KY Practitioner - Physical Therapist in Private Practice 7911355748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio County Hospital CorporationGroup PAC ID 3577477264, 84 clinicians

Practice addresses (Care Compare)

20 E McMurtry Ave
Hartford, KY 42347-1647
Phone (270) 504-1300

2841 New Hartford Rd
Owensboro, KY 42303-1320
Phone (270) 691-6161

2851 New Hartford Rd
Owensboro, KY 42303-1320
Phone (270) 688-6035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio County Hospital Corporation Current Accepting new patients
Fuller Physical Therapy Physical Therapist CurrentSince Aug 11, 2019 Accepting new patients
Ohio County Hospital Corporation CurrentSince Oct 22, 2023 Accepting new patients
Ohio County Hospital Corporation CurrentSince Oct 22, 2023 Accepting new patients

Locations

227 S Main St
Beaver Dam, KY 42320
Phone (270) 274-9221

1215 Old Main St
Hartford, KY 42347
Phone (270) 298-5401

20 E McMurtry Ave
Hartford, KY 42347
Phone (270) 504-1300

2841 New Hartford Rd
Owensboro, KY 42303
Phone (270) 691-6161

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1659926657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 S MAIN ST",
            "city": "BEAVER DAM",
            "state": "KY",
            "postal_code": "423202131",
            "telephone_number": "270-274-9221",
            "fax_number": "270-955-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 S MAIN ST",
            "city": "BEAVER DAM",
            "state": "KY",
            "postal_code": "423202131",
            "telephone_number": "270-274-9221",
            "fax_number": "270-955-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELIUS",
        "first_name": "KATLIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-06",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "007725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "007725",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver Dam, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; 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.