Individual provider Active NPI

Kaytlin Hubbert

  • Physical Therapist
  • Bonney Lake, WA
National Provider Identifier
1801650734
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
20821 Sr 410 E
Bonney Lake, WA 98391-6301
Phone
(253) 863-7510
Fax
(253) 863-5970
NPI assigned
Feb 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X LPT-033364 AZ
Physical Therapist 225100000X WA Primary

Addresses

Primary practice location

20821 Sr 410 E
Bonney Lake, WA 98391-6301

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211

Other practice location 1

17724 W Country Club Ter
Surprise, AZ 85387-4027
Phone (623) 698-6384

Other practice location 2

12162 N Rancho Vistoso Blvd Ste 120
Oro Valley, AZ 85755-1898
Phone (520) 719-4050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240301003136 AZ Practitioner - Physical Therapist in Private Practice 9032554860 Reassigns benefits to 1 organization
I20241231003322 WA Practitioner - Physical Therapist in Private Practice 9032554860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ati Holdings of Arizona LLCGroup PAC ID 2466732862, 223 clinicians
Apple Physical Therapy LLCGroup PAC ID 7810892072, 285 clinicians

Practice addresses (Care Compare)

12162 N Rancho Vistoso Blvd
Suite 120
Oro Valley, AZ 85755-1898
Phone (520) 229-0009

20821 Sr 410
Bonney Lake, WA 98391-6301
Phone (253) 863-7510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Apple Physical Therapy, LLC Physical Therapist CurrentSince Feb 3, 2025 Accepting new patients
Apple Physical Therapy LLC Physical Therapist CurrentSince Feb 3, 2025 Accepting new patients
Ati Holdings of Arizona, LLC Physical Therapist CurrentSince Feb 12, 2024 Accepting new patients

Locations

1485 E Florence Blvd
Ste 105
Casa Grande, AZ 85122
Phone (520) 494-3058

12162 N Rancho Vistoso Blvd
Ste 120
Oro Valley, AZ 85755
Phone (520) 229-0009

11209 N Tatum Blvd
Ste B120
Phoenix, AZ 85028
Phone (602) 595-0204

5110 S Rural Rd
Ste 104
Tempe, AZ 85282
Phone (480) 629-5549

1020 S Harrison Rd
Unit 120
Tucson, AZ 85748
Phone (520) 207-6288

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

20821 Sr 410 E
Bonney Lake, WA 98391
Phone (253) 863-7510

4220 Hoyt Ave
Everett, WA 98203
Phone (425) 258-5330

32030 23rd Ave S
Federal Way, WA 98003
Phone (253) 946-4852

130 Marvin Rd SE
Ste 203
Lacey, WA 98503
Phone (360) 456-3300

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": "1707696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1801650734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20821 SR 410 E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983916301",
            "telephone_number": "253-863-7510",
            "fax_number": "253-863-5970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17724 W Country Club Ter",
            "address_purpose": "LOCATION",
            "city": "Surprise",
            "state": "AZ",
            "postal_code": "853874027",
            "country_code": "US",
            "telephone_number": "623-698-6384",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12162 N Rancho Vistoso Blvd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Oro Valley",
            "state": "AZ",
            "postal_code": "857551898",
            "country_code": "US",
            "telephone_number": "520-719-4050",
            "fax_number": "520-229-0007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUBBERT",
        "first_name": "KAYTLIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-033364",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonney Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.