Kaitlyn A Dashiell, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

4039 Gateway Blvd Ste 102
Grovetown, GA 30813-3390

Phone

(706) 210-9534

Fax

(706) 210-9536

NPI assigned

Dec 12, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kaitlyn Shudark Former name

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Georgialina Physical Therapy Associates LLCGroup PAC ID 6002812401, 406 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kaitlyn.shudark.p12@direct.athleticoltd.nextgenshare.com

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.

• Georgialina Physical Therapy Associates LLC

  • Physical Therapist
  • Augusta, GA
  • NPI 1679286934
  Medicare reassignment Care Compare group NPD
• Georgialina Physical Therapy Associates LLC

  • Physical Therapy Clinic/Center
  • North Augusta, SC
  • NPI 1427164714

  Physical Therapist

  NPD

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

{
    "created_epoch": "1733961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1669289765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-1980",
            "fax_number": "410-648-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4039 GATEWAY BLVD STE 102",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308133390",
            "telephone_number": "706-210-9534",
            "fax_number": "706-210-9536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1321 Interstate Pkwy",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309095626",
            "country_code": "US",
            "telephone_number": "706-945-0810",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "250 N Louisville St",
            "address_purpose": "LOCATION",
            "city": "Harlem",
            "state": "GA",
            "postal_code": "308146012",
            "country_code": "US",
            "telephone_number": "706-986-0996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DASHIELL",
        "first_name": "KAITLYN",
        "middle_name": "A",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-12",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLYN",
            "last_name": "SHUDARK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Grovetown, GA
• Providers in Grovetown, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; 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.