Individual provider Active NPI

Katherine H Sutherland, PTA

  • Physical Therapist
  • Irmo, SC
National Provider Identifier
1700455862
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4586 Issued in SC
Practice address
7182 Woodrow St Ste 102
Irmo, SC 29063-2958
Phone
(803) 749-0808
Fax
(803) 749-0308
NPI assigned
Jun 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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 4586 SC Primary

Addresses

Primary practice location

7182 Woodrow St Ste 102
Irmo, SC 29063-2958

Mailing address

2362 Two Notch Rd
Columbia, SC 29204-2200
Phone (803) 799-7007

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4586SCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Rehabilitation Clinic, Inc. Physical Therapist CurrentSince Jun 27, 2021 Accepting new patients
Columbia Rehabilitation Clinic Physical Therapist PastSince Jun 27, 2021 Accepting new patients

Locations

2362 Two Notch Rd
Columbia, SC 29204
Phone (803) 722-8075

7182 Woodrow St
Ste 102
Irmo, SC 29063
Phone (803) 749-0808

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": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1700455862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2362 TWO NOTCH RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042200",
            "telephone_number": "803-799-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7182 WOODROW ST STE 102",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632958",
            "telephone_number": "803-749-0808",
            "fax_number": "803-749-0308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTHERLAND",
        "first_name": "KATHERINE",
        "middle_name": "H",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "4586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irmo, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.