Active NPI
Mary Katherine Hagerty, DPT
- Physical Therapist
- North Liberty, IA
National Provider Identifier
1861992893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 108068
- Practice address
- 710 Pacha Pkwy Unit 3
North Liberty, IA 52317-4824 - Phone
- (319) 855-7842
- NPI assigned
- Feb 16, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2018003458 | MO | |
| Physical Therapist | 225100000X | 298451 | CA | |
| Physical Therapist | 225100000X | 108068 | IA | Primary |
Addresses
Primary practice location
710 Pacha Pkwy Unit 3
North Liberty, IA 52317-4824
Mailing address
1464 Summerpoint LN
Fenton, MO 63026-6958
Phone (314) 445-8209
Other practice location 1
4075 N Saint Peters Pkwy
Saint Peters, MO 63304-7396
Phone (636) 685-0402
Other practice location 2
680 E Romie Ln
Salinas, CA 93901-4206
Phone (831) 758-5338
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10868 | Other | IA | STATE PT LICENSE NUMBER |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 108068 | IA | MD | Physical Therapist |
| 2018003458 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630022400000",
"number": "1861992893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1464 SUMMERPOINT LN",
"city": "FENTON",
"state": "MO",
"postal_code": "630266958",
"telephone_number": "314-445-8209",
"fax_number": "314-445-8209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 PACHA PKWY UNIT 3",
"city": "NORTH LIBERTY",
"state": "IA",
"postal_code": "523174824",
"telephone_number": "319-855-7842"
}
],
"practiceLocations": [
{
"address_1": "4075 N Saint Peters Pkwy",
"address_purpose": "LOCATION",
"city": "Saint Peters",
"state": "MO",
"postal_code": "633047396",
"country_code": "US",
"telephone_number": "636-685-0402",
"fax_number": "636-685-0403",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "680 E Romie Ln",
"address_purpose": "LOCATION",
"city": "Salinas",
"state": "CA",
"postal_code": "939014206",
"country_code": "US",
"telephone_number": "831-758-5338",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HAGERTY",
"first_name": "MARY",
"middle_name": "KATHERINE",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-16",
"last_updated": "2021-08-27",
"certification_date": "2021-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2018003458",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "298451",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "108068",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE PT LICENSE NUMBER",
"identifier": "10868",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Liberty, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.