Michael Ross Coffey, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2022003376 Issued in MO

Practice address

11902 Blue Ridge Ext Ste 11906-B
Grandview, MO 64030-1100

Phone

(816) 298-6131

Fax

(816) 298-6423

NPI assigned

Feb 7, 2022

Last updated

Feb 7, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Serc Rehabilitation Partners LLC

  • Physical Therapist
  • Grandview, MO
  • NPI 1912436627
  NPD (past)
• Serc Rebabilitation Partners, LLC

  • Physical Therapist
  • Overland Park, KS
  • NPI 1598190209
  NPD (past)

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

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1255085593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11902 BLUE RIDGE EXT STE 11906-B",
            "city": "GRANDVIEW",
            "state": "MO",
            "postal_code": "640301100",
            "telephone_number": "816-298-6131",
            "fax_number": "816-298-6423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFEY",
        "first_name": "MICHAEL",
        "middle_name": "ROSS",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-07",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "KS",
            "license": "14-03800",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2022003376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Celebraces Truman Corners Ferguson LLC
• Centerwell Senior Primary Care (Mo) PC (CenterWell Senior Primary Care -Grandview)
• Jawaria Shoaib Chatta, MD
• City of Grandview
• Trevor S Clemons, DDS
• David Cohen, MD
• Comfort Dental Grandview Aaron Parkin DMD PC
• Concentra Health Services, Inc.
• Consolidated School Dist 4
• Corrective Care KC LLC (Corrective Care KC)

• Physical Therapy Assistant in Grandview, MO
• Providers in Grandview, MO by specialty
• Physical Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; 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.