Active NPI
Agustin Ortiz Coruna III, R.P.T.
- Physical Therapist
- Sedalia, MO
National Provider Identifier
1013108406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 107084
- Practice address
- 3200 Sandstone St
Sedalia, MO 65301-8481 - Phone
- (660) 826-6042
- Fax
- (660) 826-6042
- NPI assigned
- Aug 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 107084 | MO | Primary |
Addresses
Primary practice location
3200 Sandstone St
Sedalia, MO 65301-8481
Mailing address
3200 Sandstone St
Sedalia, MO 65301-8481
Phone (660) 826-6042
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reliant Care Rehabilitative Services L L C | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapy Clinic/Center
- Columbia, MO
- NPI 1902188287
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186617600000",
"number": "1013108406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 SANDSTONE ST",
"city": "SEDALIA",
"state": "MO",
"postal_code": "653018481",
"telephone_number": "660-826-6042",
"fax_number": "660-826-6042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 SANDSTONE ST",
"city": "SEDALIA",
"state": "MO",
"postal_code": "653018481",
"telephone_number": "660-826-6042",
"fax_number": "660-826-6042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORUNA",
"first_name": "AGUSTIN",
"middle_name": "ORTIZ",
"name_suffix": "III",
"credential": "R.P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-09",
"last_updated": "2007-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "107084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sedalia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.