Individual provider Active NPI

Katherine Anne Fain, DPT

  • Physical Therapist
  • Traverse City, MI
National Provider Identifier
1689805541
Registry record updated Apr 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501014612 Issued in MI
Practice address
1650 Barlow St
Traverse City, MI 49686-4721
Phone
(231) 941-3100
Fax
(231) 922-0382
NPI assigned
Jul 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2013

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 5501014612 MI Primary

Addresses

Primary practice location

1650 Barlow St
Traverse City, MI 49686-4721

Mailing address

1650 Barlow St
Traverse City, MI 49686-4721
Phone (231) 941-3100

Other identifiers 1

IdentifierTypeStateIssuer
5501014612OtherMILICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501014612MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Natural Health Improvement Center PC PastSince May 19, 2008 Accepting new patients
Exclusive Physical Therapy Inc Physical Therapist PastSince Jan 1, 2004 Accepting new patients

Organizations & group practices 2

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": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365552000000",
    "number": "1689805541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 BARLOW ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496864721",
            "telephone_number": "231-941-3100",
            "fax_number": "231-922-0382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 BARLOW ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496864721",
            "telephone_number": "231-941-3100",
            "fax_number": "231-922-0382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIN",
        "first_name": "KATHERINE",
        "middle_name": "ANNE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-27",
        "last_updated": "2013-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501014612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "5501014612",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2013; 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.