Active NPI
Selena Claire Courtney-Koro, PT
- Physical Therapist
- Surprise, AZ
National Provider Identifier
1275800286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- X3310
- Practice address
- 14800 W Mountain View Blvd Ste 260
Surprise, AZ 85374-4797 - Phone
- (623) 556-5013
- NPI assigned
- Nov 18, 2011
- Sex
- Female
- Sole proprietor
- No
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 Therapist | 225100000X | X3310 | MI | Primary |
Addresses
Primary practice location
14800 W Mountain View Blvd Ste 260
Surprise, AZ 85374-4797
Mailing address
951 Woodside Dr
Oxford, MI 48371-6720
Phone (248) 605-5669
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X3310 | MI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arizona Infusion Centers LLC | Past | Accepting new patients | |
| Northwest Orthopedic & Sports Physical Therapy LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
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- Neurology Physician
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- NPI 1184351298
-
- Orthopedic Physical Therapist
- Sun City West, AZ
- NPI 1073610440
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508371200000",
"number": "1275800286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "951 WOODSIDE DR",
"city": "OXFORD",
"state": "MI",
"postal_code": "483716720",
"telephone_number": "248-605-5669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14800 W MOUNTAIN VIEW BLVD STE 260",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853744797",
"telephone_number": "623-556-5013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COURTNEY-KORO",
"first_name": "SELENA",
"middle_name": "CLAIRE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-18",
"last_updated": "2017-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "X3310",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.