Kathryn A Quinlan, MPT, ATC, LAT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P17276 Issued in NC

Practice address

6626 Gordon Rd Ste H
Wilmington, NC 28411-8424

Phone

(910) 798-4051

NPI assigned

May 4, 2007

Last updated

Nov 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Kathryn A Manger Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1942412424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 TRADITIONAL LN",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284115601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6626 GORDON RD STE H",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284118424",
            "telephone_number": "910-798-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINLAN",
        "first_name": "KATHRYN",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "MPT, ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "CT",
            "license": "000247",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "008467",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P17276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11931376",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lou@selfcaretherapy.com",
            "affiliation": "Y",
            "endpointDescription": "business address",
            "affiliationName": "Self Care Therapy Incorporation",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6626 Gordon Rd Ste H",
            "city": "Wilmington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284118424",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lou@selfcaretherapy.com",
            "affiliation": "N",
            "address_1": "6626 Gordon Rd Ste H",
            "city": "Wilmington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284118424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "MANGER",
            "middle_name": "A",
            "credential": "MPT,ATC,LAT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.