Cheyenne A Koki, PT, DPT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

LPT-033770 Issued in AZ

Practice address

7525 E Broadway Rd Ste 6
Mesa, AZ 85208-1156

Phone

(480) 354-2911

Fax

(480) 984-3169

NPI assigned

Jun 9, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724457600000",
    "number": "1023677572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5718",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599035718",
            "telephone_number": "406-756-0134",
            "fax_number": "406-300-1612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7525 E BROADWAY RD STE 6",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852081156",
            "telephone_number": "480-354-2911",
            "fax_number": "480-984-3169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOKI",
        "first_name": "CHEYENNE",
        "middle_name": "A",
        "credential": "PT, DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-09",
        "last_updated": "2024-08-24",
        "certification_date": "2024-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-033770",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kent Koerber
• Tatum Kofmehl, OTD R/L
• Kohala Cardiovascular Interventions LLC (Ohana Cardiology)
• Kohlhase
• Gary Clarence Kohring, D. O.
• Kendall Kokora, FNP-C
• Prashant Kolar, MD
• Katherine E Kolb, PA
• Erin Kolbus
• David Kole, D.C.

• Physical Therapist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.