Organization Active NPI

Kohout Physical Therapy, LLC

  • Orthopedic Physical Therapist
  • York, NE
National Provider Identifier
1164013116
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
KOHOUT PHYSICAL THERAPY, LLC
Practice address
115 E. 4TH Street
York, NE 68467
Phone
(402) 745-6399
Fax
(402) 745-6388
NPI assigned
Feb 2, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Authorized official

Name
Dr. Marcus Eugene Kohout, PT, DPT, OCS, SCSNPI 1841497542
Title
Ceo
Phone
(402) 469-3634

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251S0007X
Orthopedic Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251X0800X Primary

Addresses

Primary practice location

115 E. 4TH Street
York, NE 68467

Mailing address

811 S Country Club Dr
York, NE 68467-4009
Phone (402) 469-3634

Other identifiers 1

IdentifierTypeStateIssuer
10025822500MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210825000397 NE Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2264837533 Receives reassigned benefits from 1 practitioner
Practice locations: York, NE

National Provider Directory

National Provider Directory

Locations

115 E 4th St
York, NE 68467
Phone (402) 745-6399

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612224000000",
    "number": "1164013116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 S COUNTRY CLUB DR",
            "city": "YORK",
            "state": "NE",
            "postal_code": "684674009",
            "telephone_number": "402-469-3634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E. 4TH STREET",
            "city": "YORK",
            "state": "NE",
            "postal_code": "68467",
            "telephone_number": "402-745-6399",
            "fax_number": "402-745-6388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOHOUT PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-02",
        "last_updated": "2021-02-02",
        "certification_date": "2021-01-15",
        "status": "A",
        "authorized_official_last_name": "KOHOUT",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "402-469-3634",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT, OCS, SCS"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025822500",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in York, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; 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.