Active NPI
Carly Koss
- Physical Therapy Assistant
- Orlando, FL
National Provider Identifier
1174058465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 9299
- Practice address
- 3452 Lake Lynda Dr Ste 200
Orlando, FL 32817-1481 - Phone
- (440) 774-7785
- NPI assigned
- Apr 25, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 9299 | MA | Primary |
Addresses
Primary practice location
3452 Lake Lynda Dr Ste 200
Orlando, FL 32817-1481
Mailing address
2039 Canterbury Rd
Westlake, OH 44145-3227
Phone (440) 655-5143
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9299 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493078400000",
"number": "1174058465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2039 CANTERBURY RD",
"city": "WESTLAKE",
"state": "OH",
"postal_code": "441453227",
"telephone_number": "440-655-5143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3452 LAKE LYNDA DR STE 200",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328171481",
"telephone_number": "440-774-7785"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOSS",
"first_name": "CARLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-25",
"last_updated": "2017-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MA",
"license": "9299",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.