Active NPI
Kaitlynn Donovan Kowalick, DPT
- Physical Therapist
- Raleigh, NC
National Provider Identifier
1922501188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P20929
- Practice address
- 3701 Wake Forest Rd
Raleigh, NC 27609-6832 - Phone
- (919) 350-1508
- NPI assigned
- Mar 14, 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 872087 | DC | |
| Orthopedic Physical Therapist | 2251X0800X | CP005111T | NC | |
| Physical Therapist | 225100000X | P20929 | NC | Primary |
Addresses
Primary practice location
3701 Wake Forest Rd
Raleigh, NC 27609-6832
Mailing address
PO Box 603949
Charlotte, NC 28260-3949
Phone (919) 350-0351
Other practice location 1
110 Kildaire Park Dr
Cary, NC 27518-8162
Phone (919) 235-1989
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922501188 | Medicaid | NC |
Other names 1
- Kait Donovan
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 |
|---|---|---|---|
| 872087 | DC | MD | Pediatric Physical Therapist |
| CP005111T | NC | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649721600000",
"number": "1922501188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 603949",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282603949",
"telephone_number": "919-350-0351",
"fax_number": "919-350-7687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3701 WAKE FOREST RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276096832",
"telephone_number": "919-350-1508"
}
],
"practiceLocations": [
{
"address_1": "110 Kildaire Park Dr",
"address_purpose": "LOCATION",
"city": "Cary",
"state": "NC",
"postal_code": "275188162",
"country_code": "US",
"telephone_number": "919-235-1989",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KOWALICK",
"first_name": "KAITLYNN",
"middle_name": "DONOVAN",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-14",
"last_updated": "2022-04-12",
"certification_date": "2022-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "DC",
"license": "872087",
"primary": false
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "NC",
"license": "CP005111T",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P20929",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1922501188",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KAIT",
"last_name": "DONOVAN",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.