Individual provider Active NPI

Kathrina Mae Inchoco

  • Physical Therapist
  • Ardmore, PA
National Provider Identifier
1689330870
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT029937 Issued in PA
Practice address
233 E Lancaster Ave Ste 100
Ardmore, PA 19003-2321
Phone
(610) 642-4494
NPI assigned
Nov 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA02010100 NJ
Physical Therapist 225100000X PT029937 PA Primary

Addresses

Primary practice location

233 E Lancaster Ave Ste 100
Ardmore, PA 19003-2321

Mailing address

401 Race St Ste D
Philadelphia, PA 19106-1024
Phone (215) 255-5431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211229000574 PA Practitioner - Physical Therapist in Private Practice 2668863796 Reassigns benefits to 2 organizations
I20240411003482 NJ Practitioner - Physical Therapist in Private Practice 2668863796 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA02010100NJMDPhysical Therapist
PT029937PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Novacare Outpatient Rehabilitation East, Inc. CurrentSince Nov 15, 2021 Accepting new patients
Rehabclinics SPT, Inc. CurrentSince Nov 15, 2021 Accepting new patients
Novacare Outpatient Rehabilitation East, Inc. Physical Therapist Current Accepting new patients
Ivyrehab Network Inc. Physical Therapist CurrentSince Apr 10, 2024 Accepting new patients
Novacare Outpatient Rehabilitation East Inc CurrentSince Nov 15, 2021 Accepting new patients
Rehabclinics (SPT), Inc. Physical Therapist CurrentSince Nov 15, 2021 Accepting new patients
Ivyrehab Network, Inc. Physical Therapist CurrentSince Apr 10, 2024 Accepting new patients
Rehabclinics Galaxy Inc PastSince Nov 16, 2021 Accepting new patients

Locations

731 Lacey Rd
Ste 3
Forked River, NJ 08731
Phone (609) 242-6780

454 Passaic St
Hackensack, NJ 07601
Phone (201) 488-7905

1007 Mantua Pike
West Deptford, NJ 08096
Phone (856) 845-1253

233 E Lancaster Ave
Ste 100
Ardmore, PA 19003
Phone (610) 642-4494

352 Railroad St
Ligonier, PA 15658
Phone (724) 238-3301

604 Commons Dr
Ste D3
Oxford, PA 19363
Phone (610) 932-3619

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1636588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1689330870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 RACE ST STE D",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191061024",
            "telephone_number": "215-255-5431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 E LANCASTER AVE STE 100",
            "city": "ARDMORE",
            "state": "PA",
            "postal_code": "190032321",
            "telephone_number": "610-642-4494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INCHOCO",
        "first_name": "KATHRINA",
        "middle_name": "MAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-11",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02010100",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT029937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.