Individual provider Active NPI

Kathryn Jean Koehn, M.P.T.

  • Physical Therapist
  • Sioux Falls, SD
National Provider Identifier
1164570743
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0540 Issued in SD
Practice address
1721 S Cleveland Ave
Suite 200
Sioux Falls, SD 57103-5501
Phone
(605) 582-8718
Fax
(605) 582-8734
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 0540 SD Primary

Addresses

Primary practice location

1721 S Cleveland Ave
Suite 200
Sioux Falls, SD 57103-5501

Mailing address

615 Lakota CT
Brandon, SD 57005-1934
Phone (605) 582-3385

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090212000671 SD Practitioner - Physical Therapist in Private Practice 0840355574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

103 N Splitrock Blvd
Brandon, SD 57005-1529
Phone (605) 582-3908

300 W 5TH St
Miller, SD 57362-1238
Phone (605) 853-0158

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Oct 1, 2008 Accepting new patients
Avera McKennan CurrentSince Oct 1, 2008 Accepting new patients
Physical Therapy Solutions, Inc. Physical Therapist Past Accepting new patients
Avera McKennan Past Accepting new patients

Locations

103 N Splitrock Blvd
Brandon, SD 57005
Phone (605) 582-3908

909 N Iowa Ave
Dell Rapids, SD 57022
Phone (605) 428-5431

300 W 5th St
Miller, SD 57362
Phone (605) 853-0158

Organizations & group practices 4

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164570743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 LAKOTA CT",
            "city": "BRANDON",
            "state": "SD",
            "postal_code": "570051934",
            "telephone_number": "605-582-3385",
            "fax_number": "605-582-8734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 S CLEVELAND AVE",
            "address_2": "SUITE 200",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571035501",
            "telephone_number": "605-582-8718",
            "fax_number": "605-582-8734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEHN",
        "first_name": "KATHRYN",
        "middle_name": "JEAN",
        "credential": "M.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SD",
            "license": "0540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.