Individual provider Active NPI

Kathryn Maris Hauge, PT

  • Physical Therapist
  • Sioux City, IA
National Provider Identifier
1770177347
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
105253 Issued in IA
Practice address
2800 Pierce St Ste 120B
Sioux City, IA 51104-3755
Phone
(712) 279-3178
Fax
(712) 279-3467
NPI assigned
Feb 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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 105253 IA Primary

Addresses

Primary practice location

2800 Pierce St Ste 120B
Sioux City, IA 51104-3755

Mailing address

2800 Pierce St Ste 120B
Sioux City, IA 51104-3755
Phone (712) 279-3178

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210525002295 SD Practitioner - Physical Therapist in Private Practice 9830598887
I20210525002843 IA Practitioner - Physical Therapist in Private Practice 9830598887 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iowa Physicians Clinic Medical FoundationGroup PAC ID 8729992318, 1,254 clinicians

Practice addresses (Care Compare)

4480 Utica Ridge Rd
Bettendorf, IA 52722-1644

5885 Sunnybrook Dr
Sioux City, IA 51106-4250

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2299SDMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cnos, PC CurrentSince Feb 22, 2021 Accepting new patients
Cnos PC CurrentSince Feb 22, 2021 Accepting new patients
Iowa Physicians Clinic Medical Foundation CurrentSince Aug 21, 2023 Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

5708 Sunnybrook Ct
Sioux City, IA 51106

2735 Outer Dr N
Sioux City, IA 51104
Phone (712) 224-5692

5885 Sunnybrook Dr
Ste D100
Sioux City, IA 51106
Phone (712) 266-2700

2720 Stone Park Blvd
Sioux City, IA 51104
Phone (712) 259-3000

575 N Sioux Point Rd
North Sioux City, SD 57049
Phone (605) 217-2615

Organizations & group practices 3

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": "1614124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1770177347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 PIERCE ST STE 120B",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511043755",
            "telephone_number": "712-279-3178",
            "fax_number": "712-279-3467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 PIERCE ST STE 120B",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511043755",
            "telephone_number": "712-279-3178",
            "fax_number": "712-279-3467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUGE",
        "first_name": "KATHRYN",
        "middle_name": "MARIS",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-24",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "105253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; 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.