Individual provider Active NPI

Katherine Levine Nickerson, P.T.

  • Physical Therapist
  • Cupertino, CA
National Provider Identifier
1891023859
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
17070 Issued in CA
Practice address
20823 Stevens Creek Blvd
Suite #200
Cupertino, CA 95014-2108
Phone
(408) 252-6076
Fax
(408) 252-1159
NPI assigned
Dec 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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 17070 CA Primary

Addresses

Primary practice location

20823 Stevens Creek Blvd
Suite #200
Cupertino, CA 95014-2108

Mailing address

20823 Stevens Creek Blvd
Cupertino, CA 95014-2108
Phone (408) 833-3465

Other names 1

  • Ms. Kate Levine Former name

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

LicenseStateTypeSpecialty
17070CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
B.E.S.T. Physical Therapy, a Prof Corp Physical Therapist PastSince May 20, 2010 Accepting new patients

Organizations & group practices 1

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": "1259712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1891023859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20823 STEVENS CREEK BLVD",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950142108",
            "telephone_number": "408-833-3465",
            "fax_number": "408-440-0409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20823 STEVENS CREEK BLVD",
            "address_2": "SUITE #200",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950142108",
            "telephone_number": "408-252-6076",
            "fax_number": "408-252-1159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "KATHERINE",
        "middle_name": "LEVINE",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-02",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "17070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATE",
            "last_name": "LEVINE",
            "prefix": "MS.",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cupertino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.