Individual provider Active NPI

Kathryn L McMahon, P.T.A.

  • Physical Therapy Assistant
  • Monroe, MI
National Provider Identifier
1730437567
Registry record updated Aug 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
5502003718 Issued in MI
Practice address
930 S Telegraph Rd
Monroe, MI 48161-4097
Phone
(419) 472-0900
Fax
(419) 472-0812
NPI assigned
Aug 28, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 5502003718 MI Primary

Addresses

Primary practice location

930 S Telegraph Rd
Monroe, MI 48161-4097

Mailing address

930 S Telegraph Rd
Monroe, MI 48161-4097
Phone (419) 472-0900

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
5502003718MIMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Essentials Past Accepting new patients
Therapy Essentials Past 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": "1346112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346112000000",
    "number": "1730437567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 S TELEGRAPH RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481614097",
            "telephone_number": "419-472-0900",
            "fax_number": "419-472-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 S TELEGRAPH RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481614097",
            "telephone_number": "419-472-0900",
            "fax_number": "419-472-0812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHON",
        "first_name": "KATHRYN",
        "middle_name": "L",
        "credential": "P.T.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-28",
        "last_updated": "2012-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502003718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; 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.