Katie Deroo, D.P.T.

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

5501015392 Issued in MI

Practice address

235 Wealthy St SE
Grand Rapids, MI 49503-5247

Phone

(616) 840-8000

NPI assigned

Nov 26, 2014

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Molly Buist & Associates Inc

  • Occupational Therapist
  • Jenison, MI
  • NPI 1134403694
  NPD (past)

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

{
    "created_epoch": "1416960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519862400000",
    "number": "1700283249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5867 WALNUT RIDGE DR SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "494188347",
            "telephone_number": "616-299-4025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 WEALTHY ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035247",
            "telephone_number": "616-840-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROO",
        "first_name": "KATIE",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-26",
        "last_updated": "2018-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "MI",
            "license": "5501015392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dermatology at Midtowne, PC
• Dermatology Center of Grand Rapids PC
• Dermatology Specialists of Grand Rapids, PLLC
• James Dernocoeur, PA
• Heidi Ruth Deroo, LMSW
• Steven T Deroos, MD
• Kathleen Anne Derosa Belmont, DC
• Elizabeth Morrow Derose, MD
• Anna Derr
• Heather A Derrick, LLBSW

• Pediatric Physical Therapist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Pediatric Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2018; 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.