Individual provider Active NPI

Kayla Koren

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1275210858
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-33073 Issued in AZ
Practice address
15905 S 46TH St Ste 140
Phoenix, AZ 85048-2206
Phone
(480) 805-8304
Fax
(480) 805-8304
NPI assigned
Jul 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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 LPT-33073 AZ Primary

Addresses

Primary practice location

15905 S 46TH St Ste 140
Phoenix, AZ 85048-2206

Mailing address

PO Box 5718
Kalispell, MT 59903-5718
Phone (406) 756-0134

Other practice location 1

1027 Bellevue Ave Ste 15
Richmond Heights, MO 63117-1851
Phone (314) 768-5375

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240219003761 AZ Practitioner - Physical Therapist in Private Practice 5991149882 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPT-33073AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Waits Physical Therapy LLC Physical Therapist CurrentSince Nov 5, 2024 Accepting new patients
The Pelvic Docs, LLC Physical Therapist CurrentSince Jan 3, 2025 Accepting new patients
Harvest Physical Therapy, LLC Physical Therapist CurrentSince Jan 3, 2025 Accepting new patients

Locations

580 N Camino Mercado
Ste 25
Casa Grande, AZ 85122
Phone (520) 836-8621

225 E Germann Rd
Ste 250
Gilbert, AZ 85297

15905 S 46th St
Ste 140
Phoenix, AZ 85048
Phone (480) 805-8304

Organizations & group practices 3

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": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1275210858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5718",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599035718",
            "telephone_number": "406-756-0134",
            "fax_number": "406-300-1612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15905 S 46TH ST STE 140",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850482206",
            "telephone_number": "480-805-8304",
            "fax_number": "480-805-8304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1027 Bellevue Ave Ste 15",
            "address_purpose": "LOCATION",
            "city": "Richmond Heights",
            "state": "MO",
            "postal_code": "631171851",
            "country_code": "US",
            "telephone_number": "314-768-5375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOREN",
        "first_name": "KAYLA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-05",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-33073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.