Individual provider Active NPI

Cole Reilley Koontz, PT, DPT, LAT, ATC

  • Physical Therapist
  • Wheeling, WV
National Provider Identifier
1174496541
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT004826 Issued in WV
Practice address
1 Medical Park
Wheeling, WV 26003-6379
Phone
(304) 243-3000
NPI assigned
Sep 24, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT001835 WV
Physical Therapist 225100000X PT004826 WV Primary

Addresses

Primary practice location

1 Medical Park
Wheeling, WV 26003-6379

Mailing address

4451 Fairmont Pike Rd
Wheeling, WV 26003-7696

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

LicenseStateTypeSpecialty
PT004826WVMDPhysical Therapist
AT001835WVMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1758672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1174496541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4451 FAIRMONT PIKE RD",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260037696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260036379",
            "telephone_number": "304-243-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONTZ",
        "first_name": "COLE",
        "middle_name": "REILLEY",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-24",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WV",
            "license": "AT001835",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "PT004826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2025; 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.