Koth Sports Physical Therapy, PA

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

KOTH SPORTS PHYSICAL THERAPY, PA

Practice address

101 Saddle Road
Ketchum, ID 83340-1510

Phone

(208) 726-9222

Fax

(208) 726-1607

NPI assigned

Sep 29, 2006

Last updated

Jan 21, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sherri L Koth

Title

Its Secretary/Treasurer, Its Bus MG

Phone

(208) 788-3997

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Karoline A Droege, MPT

  • Physical Therapist
  • Ketchum, ID
  • NPI 1730271511
  NPD (past)
• John C Koth, MPT

  • Physical Therapist
  • Ketchum, ID
  • NPI 1124110002
  NPD (past)

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390262400000",
    "number": "1265524045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "KETCHUM",
            "state": "ID",
            "postal_code": "833401510",
            "telephone_number": "208-788-3997",
            "fax_number": "208-726-1607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SADDLE ROAD",
            "city": "KETCHUM",
            "state": "ID",
            "postal_code": "833401510",
            "telephone_number": "208-726-9222",
            "fax_number": "208-726-1607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOTH SPORTS PHYSICAL THERAPY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2014-01-21",
        "status": "A",
        "authorized_official_last_name": "KOTH",
        "authorized_official_first_name": "SHERRI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ITS SECRETARY/TREASURER, ITS BUS MG",
        "authorized_official_telephone_number": "208-788-3997"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "DC6231",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caroline C Keeney, NP-C
• Lauren Keppler, NMD
• Ketchum Family Medicine, PLLC
• Kimberly a Vorse MD PC
• Kimberly a. Vorse MD PC (Sleep Evaluation Labs)
• John C Koth, MPT
• Jeffrey Arnold Kovnick, M.D.
• David Laxson, M.D.
• Coleman Joshua Lay, OTR/L
• Allen Leavitt, PHARMD

• Physical Therapist in Ketchum, ID
• Providers in Ketchum, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; 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.