Haley Anne Koppenhaver, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

TEI005631 Issued in PA

Practice address

76 Rehab LN
Danville, PA 17822-0001

Phone

(570) 271-6110

NPI assigned

Aug 4, 2021

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1628035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1164196135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 TREVORTON RD",
            "city": "COAL TOWNSHIP",
            "state": "PA",
            "postal_code": "178667706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 REHAB LN",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178220001",
            "telephone_number": "570-271-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPPENHAVER",
        "first_name": "HALEY",
        "middle_name": "ANNE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-04",
        "last_updated": "2021-08-04",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TEI005631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0094",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Haleyanne94",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "76 Rehab Ln",
            "city": "Danville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178220001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Janienne Ellen Kondrich, MD
• Stephen Konkolics, PA-C
• Kirsten Lee Koons, M.D.
• Daniel Brian Koontz, RPH
• Kathryn Kopelcheck, RPH
• Jillian Ann Korgeski, PA-C
• Karen A Korzick, MD
• George Vivek Koshy, DO
• Matthew Nickolas Kostelac
• Camille Alexandra Kotcho

• Physical Therapy Assistant in Danville, PA
• Providers in Danville, PA by specialty
• Physical Therapy Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; 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.