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ILANA NICOLE KELLOGG WAASDORP PT DPT NPI 1720425549


NPI Information

NPI: 1720425549
Provider Name: ILANA NICOLE KELLOGG WAASDORP, PT, DPT
Classification: Physical Therapist - 2251P0200X
Entity Type: Individual

Specialization: Pediatrics

Address:
1421 3RD ST SW
ROANOKE, VA
ZIP 24016
Phone: (303) 900-3457
Get Directions

Ilana Nicole Kellogg Waasdorp, PT, DPT is a pediatrics physical therapist in Roanoke, VA. The provider is a licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, genetics, biomechanics, neurological function, neuroscience, and pathology, behavioral sciences, and understanding of diseases or conditions that necessitate physical therapy care, that affect systems that in turn necessitate physical therapy care (comorbidities), and that influence the type of intervention that can be given. Ilana Nicole Kellogg Waasdorp, PT, DPT NPI is 1720425549. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1421 3RD ST SW
ROANOKE, VA
ZIP 24016-204
Phone: (303) 900-3457

The enumeration date for this NPI number is 6/3/2013 and was last updated on 1/2/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1225100000XPhysical TherapistPTL.0012174COLORADONo
22251P0200XPhysical TherapistPediatrics2305212941VIRGINIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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