Individual provider Active NPI

Kathleen Diana Sidener, P.T., CERT. M.D.T.

  • Specialist
  • Reno, NV
National Provider Identifier
1689755936
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0364 Issued in NV
Practice address
15 McCabe Dr Ste 101
Reno, NV 89511-4815
Phone
(775) 788-5599
Fax
(775) 788-5598
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0364 NV Primary

Addresses

Primary practice location

15 McCabe Dr Ste 101
Reno, NV 89511-4815

Mailing address

15 McCabe Dr Ste 101
Reno, NV 89511-4815
Phone (775) 788-5599

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110302000534 NV Practitioner - Physical Therapist in Private Practice 8123072931 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sidener Physical Therapy LLCGroup PAC ID 9436103249, 12 clinicians

Practice addresses (Care Compare)

15 McCabe Dr
Suite 101
Reno, NV 89511-4815
Phone (775) 788-5599

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14558CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sidener Physical Therapy LLC Specialist CurrentSince Mar 1, 1999 Accepting new patients

Locations

15 McCabe Dr
Ste 101
Reno, NV 89511
Phone (775) 331-3030

4798 Caughlin Pkwy
Ste B
Reno, NV 89519
Phone (775) 284-4774

970 Roberta Ln
Ste 100
Sparks, NV 89431
Phone (775) 331-3030

Organizations & group practices 1

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1689755936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 MCCABE DR STE 101",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895114815",
            "telephone_number": "775-788-5599",
            "fax_number": "775-788-5598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MCCABE DR STE 101",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895114815",
            "telephone_number": "775-788-5599",
            "fax_number": "775-788-5598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDENER",
        "first_name": "KATHLEEN",
        "middle_name": "DIANA",
        "credential": "P.T., CERT. M.D.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NV",
            "license": "0364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.