Breana Lynn Koffler, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

7869 Issued in CO

Practice address

413 Summit Blvd
Suite 102
Broomfield, CO 80021-8294

Phone

(303) 499-6565

Fax

(303) 499-8585

NPI assigned

May 17, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292976000000",
    "number": "1043428873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10650 YATES DR",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800311984",
            "telephone_number": "303-912-4959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 SUMMIT BLVD",
            "address_2": "SUITE 102",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800218294",
            "telephone_number": "303-499-6565",
            "fax_number": "303-499-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOFFLER",
        "first_name": "BREANA",
        "middle_name": "LYNN",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2010-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "7869",
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LISCENSE NUMBER",
            "identifier": "7869",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory Alan Klob, RPH
• Laura 'Laurie' VH Knight, B.A. PSYCHOTHERAPIST
• Sara Knorr
• Nancy Jean Knudtsen, CD (DONA)
• Mark Kochevar, D.C.
• Elisabeth Margarita Komlos-Hrobsky, PH.D
• Konda Chiropractic LLC
• Stephanie Konter-O'Hara
• Holly Kosanovich, MS, CCC-SLP
• Adam Kosofsky, OTR/L

• Physical Therapist in Broomfield, CO
• Providers in Broomfield, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.