Kate Bourdlais, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501016357 Issued in MI

Practice address

15400 Northline Rd
Southgate, MI 48195-2689

Phone

(734) 284-1066

Fax

(734) 284-9865

NPI assigned

Jan 2, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kate Schmoekel Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1388620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513555200000",
    "number": "1780005173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480354258",
            "telephone_number": "586-350-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15400 NORTHLINE RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952689",
            "telephone_number": "734-284-1066",
            "fax_number": "734-284-9865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURDLAIS",
        "first_name": "KATE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-02",
        "last_updated": "2017-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501016357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATE",
            "last_name": "SCHMOEKEL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Laquitta Tyisha Bosley
• Jillian Bostain
• Charlie Bothuell
• Mia Boulay
• Kaylen Bourdage
• Jamel Cameron Bowers
• Amanda Lauren Bowman- Collins, PA-C
• Arieanna Bowman
• Jessica Marie Bowman, LLP, CIC-CPP, C-DBT
• Charlene Boyd

• Physical Therapist in Southgate, MI
• Providers in Southgate, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2017; 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.