Physician Compare National (NPI:1699198416)

HEALTHCARE PROVIDER: KATHLEEN C. COUGHLIN DPT, PT

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1699198416
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7214169564
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190925003067
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	COUGHLIN
	Individual professional last name
Provider First Name	KATHLEEN
	Individual professional first name
Provider Middle Name	C
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2013
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL THERAPY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	235 PLAIN ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 307
	Group Practice or individual's line 2 address
City	PROVIDENCE
	Group Practice or individual's city
State	RI
	Group Practice or individual's state
Zip Code	029053243
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y