Kathryn Elizabeth Jacques, MPT
NPI 1245470210ActiveIndividual· Physical Therapist· Fort Defiance, AZ
Physical Therapist (MPT) with Southcentral Foundation, practicing in Fort Defiance, Arizona. Enrolled in Medicare as practitioner - physical therapist in private practice.
Overview
| NPI | 1245470210 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MPT |
| Sole proprietor | Yes |
| NPI issued | Mar 3, 2009 |
| Last updated in NPPES | Aug 20, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | PHYP2898 | AK |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (TX) |
|---|
Education and affiliations
| Graduation year | 2009 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Southcentral FoundationWasilla, AK · 167 clinicians
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