| Erin Katie Idacavage, PT, MPT, GCS | |
|
1004 Progress Dr Ste 100, Lansing, KS 66043-6323 | |
| (913) 351-3838 | |
| (913) 351-3939 |
| Full Name | Erin Katie Idacavage |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 1004 Progress Dr Ste 100, Lansing, Kansas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225134349 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 2014005585 (Missouri) | Secondary |
| 225100000X | Physical Therapist | 11-03556 (Kansas) | Primary |
| Provider Name | Bluestem Therapy Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1770219248 PECOS PAC ID: 4688041734 Enrollment ID: O20221103000298 |
| Mailing Address | Practice Location Address |
|---|---|
| Erin Katie Idacavage, PT, MPT, GCS 6397 Lee Hwy Ste 300, Chattanooga, TN 37421-2564 Ph: (423) 238-7217 | Erin Katie Idacavage, PT, MPT, GCS 1004 Progress Dr Ste 100, Lansing, KS 66043-6323 Ph: (913) 351-3838 |
Katherine Marie Martin, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 712 1st Ter, Ste 103, Lansing, KS 66043 Phone: 913-727-2022 Fax: 913-727-2033 | |
Mike A Mendiola, BS Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1004 Progress Dr, Ste 100, Lansing, KS 66043 Phone: 913-351-3838 Fax: 913-351-3939 | |
Leif Erick Sanford, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 100 E Kansas St Ste C, Lansing, KS 66043 Phone: 913-758-0283 | |
Trisha M. Mcculloch, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 712 1st Ter, Ste 103, Lansing, KS 66043 Phone: 913-727-2022 Fax: 913-727-2033 | |
Linda A Stelter, RPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 210 N Plaza Dr, Lansing, KS 66043 Phone: 913-727-1284 | |
Jason S Langford, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1004 Progress Dr, Suite 100, Lansing, KS 66043 Phone: 913-351-3838 Fax: 913-351-3939 |