Katelyn Sage, DPT

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

License

7683 Issued in SC

Practice address

4394 Route 16
Shipman, IL 62685-6062

Phone

(618) 535-0188

NPI assigned

Aug 31, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Katelyn Christopher Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1689041295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 ABERDEEN DR",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620348533",
            "telephone_number": "618-535-0188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4394 ROUTE 16",
            "city": "SHIPMAN",
            "state": "IL",
            "postal_code": "626856062",
            "telephone_number": "618-535-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAGE",
        "first_name": "KATELYN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-31",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "SC",
            "license": "7683",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "SC",
            "license": "7683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "CHRISTOPHER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shana B Bertels, COTA
• Traci Marie Hartrich, OTR/L
• Richelle Rees Hannah, BA, RBT
• Lisa Marie Reid, FNP
• Therakids, P.C.
• Kathryn E Wassink, OTR/L
• Katherine L Whitworth, MS OTR/L
• Hannah Elise Wittman, M.A., CFY-SLP

• Rehabilitation Clinic/Center in Shipman, IL
• Providers in Shipman, IL by specialty
• Rehabilitation Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; 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.