Individual provider Active NPI

Katherine Williams

  • Physical Therapist
  • Venice, FL
National Provider Identifier
1770197063
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT36080 Issued in FL
Practice address
3030 Executive Dr
Venice, FL 34292-2613
Phone
(941) 485-1505
Fax
(941) 485-7495
NPI assigned
Sep 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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 PT36080 FL Primary

Addresses

Primary practice location

3030 Executive Dr
Venice, FL 34292-2613

Mailing address

3030 Executive Dr
Venice, FL 34292-2613
Phone (941) 485-1505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200921001834 FL Practitioner - Physical Therapist in Private Practice 6800214081 Reassigns benefits to 3 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
Suncoast Orthopaedic Surgery and Sports Medicine, P.a.Group PAC ID 0648296285, 14 clinicians

Practice addresses (Care Compare)

3030 Executive Dr
Venice, FL 34292-2613
Phone (941) 485-1505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT36080FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Performance and Physical Therapies St. Petersburg, LLC Physical Therapist CurrentSince Nov 9, 2020 Accepting new patients
Physical Therapy Services of Flatiron PC Physical Therapist CurrentSince Apr 1, 2023 Accepting new patients
Suncoast Orthopaedic Surgery & Sports Medicine, P.a. CurrentSince Feb 16, 2024 Accepting new patients
Physical Therapy Now Holdings, LLC Physical Therapist Past Accepting new patients

Locations

21756 State Road 54
Ste 102
Lutz, FL 33549
Phone (813) 279-6234

111 N Orange Ave
Ste 800
Orlando, FL 32801
Phone (212) 287-4257

1700 66th St N
Ste 102
St Petersburg, FL 33710
Phone (727) 202-4627

2600 Dr Martin Luther King Jr St N
Ste 200B
St Petersburg, FL 33704
Phone (727) 202-4625

3030 Executive Dr
Venice, FL 34292
Phone (941) 485-1505

836 Sunset Lake Blvd
Ste 205A
Venice, FL 34292
Phone (941) 485-1505

138 5th Ave
Fl 2
New York, NY 10011
Phone (212) 287-4257

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 4

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": "1599091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1770197063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 EXECUTIVE DR",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342922613",
            "telephone_number": "941-485-1505",
            "fax_number": "941-485-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 EXECUTIVE DR",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342922613",
            "telephone_number": "941-485-1505",
            "fax_number": "941-485-7495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-03",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT36080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.