Brenda J Coakley, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

06000104A Issued in IN

Practice address

9190 Priority Way West Dr Ste 110
Indianapolis, IN 46240-1437

Phone

(317) 805-4963

Fax

(317) 818-0720

NPI assigned

May 21, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Indiana Fitness Works Inc

  • Physical Therapist
  • Indianapolis, IN
  • NPI 1942449699
  NPD (past)

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

{
    "created_epoch": "1242864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242864000000",
    "number": "1093940926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9190 PRIORITY WAY WEST DR STE 110",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462401437",
            "telephone_number": "317-805-4963",
            "fax_number": "317-818-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9190 PRIORITY WAY WEST DR STE 110",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462401437",
            "telephone_number": "317-805-4963",
            "fax_number": "317-818-0720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COAKLEY",
        "first_name": "BRENDA",
        "middle_name": "J",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-21",
        "last_updated": "2009-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06000104A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• CMT Heart Mobility & Transport LLC
• CMW Medical LLC
• Coach Dreammakers L.L.C.
• Coach Dreammakers LLC
• Ashley N Coak, NP
• Kyle R Coates, MS, ATC, LAT
• Lula Coates, MSW
• Pamela S Coates, RD
• Aundrea Diane Coath, RBT
• Bailey Coatie, LCSW

• Physical Therapy Assistant in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Physical Therapy Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2009; 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.