Kathryn Marie Boaldin, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

03885 Issued in IA

Practice address

815 W Tower Park Dr
Waterloo, IA 50701-9026

Phone

(319) 233-6995

Fax

(319) 233-7083

NPI assigned

Mar 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kathryn Marie Hanish Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rock Valley Physical Therapy Center

  • Occupational Therapist
  • Eldridge, IA
  • NPI 1881540490

  Physical Therapist

  NPD
• Rock Valley Physical Therapy Center

  • Physical Therapist
  • Moline, IL
  • NPI 1245373166
  NPD

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334102400000",
    "number": "1902874944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 43RD AVE",
            "address_2": "STE 100",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612658401",
            "telephone_number": "309-743-2070",
            "fax_number": "309-743-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 W TOWER PARK DR",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507019026",
            "telephone_number": "319-233-6995",
            "fax_number": "319-233-7083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOALDIN",
        "first_name": "KATHRYN",
        "middle_name": "MARIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2012-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "03885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA PT LICENSE",
            "identifier": "03885",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "HANISH",
            "middle_name": "MARIE",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Black Hawk-Grundy Mental Health Center Inc.
• Natalie Ann Bloom, ARNP, FNP-C
• Michael J Blough, DC
• Rachel Sue Blough
• Wayde Russell Blumhardt, CRNA
• Bryan Boardsen, MOT
• Ann Marie Bock, MSN,ARNP, FNP-C
• Zubair Hassan Bodla, M.D.
• Steven D Boeke, O.D.
• Vinko M Bogdanic, M.D.

• Physical Therapist in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2012; 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.