Katrina Blaine Moreland, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

04015 Issued in IA

Practice address

5900 NW 86TH St
Suite 200
Johnston, IA 50131-2284

Phone

(515) 278-8151

Fax

(515) 278-8155

NPI assigned

Mar 22, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1932226461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15910 TANGLEWOOD DR",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503232282",
            "telephone_number": "515-278-8151",
            "fax_number": "515-276-3194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 NW 86TH ST",
            "address_2": "SUITE 200",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312284",
            "telephone_number": "515-278-8151",
            "fax_number": "515-278-8155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORELAND",
        "first_name": "KATRINA",
        "middle_name": "BLAINE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "04015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0665430",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; 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.