Provider Demographics
NPI:1801182597
Name:RHODES, KATE M (PT)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:M
Last Name:RHODES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:M
Other - Last Name:LAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1314 EDWIN MILLER BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25404-5717
Mailing Address - Country:US
Mailing Address - Phone:304-728-1750
Mailing Address - Fax:
Practice Address - Street 1:1314 EDWIN MILLER BLVD STE 101
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25404-5717
Practice Address - Country:US
Practice Address - Phone:304-728-1750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV002669208100000X
MD22685225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH571OtherMEDICARE GROUP ID
WV2524Medicaid