Individual provider Active NPI

Hendrika F. Koole, PT

  • Physical Therapist
  • Charlotte, NC
National Provider Identifier
1043295488
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5239 Issued in NC
Practice address
2400 W Mallard Creek Church Rd
Charlotte, NC 28262-2324
Phone
(704) 323-2108
NPI assigned
Dec 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5239 NC Primary

Addresses

Primary practice location

2400 W Mallard Creek Church Rd
Charlotte, NC 28262-2324

Mailing address

PO Box 601791
Charlotte, NC 28260-1791
Phone (704) 323-2000

Other practice location 1

9848 North Tryon Street
Ste 200
Charlotte, NC 28262
Phone (704) 323-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070810000548 NC Practitioner - Physical Therapist in Private Practice 5991896565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5239NCMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthocarolina Physical Therapist CurrentSince May 24, 2007 Accepting new patients
Orthocarolina Physical Therapist Current Accepting new patients
Orthocarolina Physical Therapist CurrentSince May 24, 2007 Accepting new patients
Orthocarolina Physical Therapist Past Accepting new patients
Foundation Health Systems LLC Physical Therapist Past Accepting new patients
University Surgery Center LLC Past Accepting new patients

Locations

2400 W Mallard Creek Church Rd
Charlotte, NC 28262
Phone (704) 323-2090

4601 Park Rd
Ste 300
Charlotte, NC 28209
Phone (704) 323-2090

1915 Randolph Rd
Charlotte, NC 28207
Phone (704) 339-1000

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1043295488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601791",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601791",
            "telephone_number": "704-323-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 W MALLARD CREEK CHURCH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282622324",
            "telephone_number": "704-323-2108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9848 North Tryon Street",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28262",
            "country_code": "US",
            "telephone_number": "704-323-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOOLE",
        "first_name": "HENDRIKA",
        "middle_name": "F.",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-08",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "5239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.