Koop Family Physical Therapy LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

009627 Issued in OH

Legal business name

KOOP FAMILY PHYSICAL THERAPY LLC

Practice address

4859 W Sylvania Ave Ste a
Toledo, OH 43623-3372

Phone

(419) 471-0400

Fax

(419) 471-0403

NPI assigned

Oct 13, 2006

Last updated

Nov 30, 2022By 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

Mr. Michelle Lee Shine Koop, DPTNPI 1720178551

Title

Member of LLC

Phone

(419) 471-0400

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 3

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.

• Douglas P Koop, DPT

  • Physical Therapist
  • Toledo, OH
  • NPI 1558364455
  Medicare reassignment NPD
• Michelle Lee Shine Koop, DPT

  • Physical Therapist
  • Toledo, OH
  • NPI 1720178551
  Authorized official Same address or phone
• Teresa S Badenhop, PT

  • Physical Therapist
  • Toledo, OH
  • NPI 1891981965
  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669766400000",
    "number": "1285724039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4859 W SYLVANIA AVE STE A",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436233372",
            "telephone_number": "419-471-0400",
            "fax_number": "419-471-0403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4859 W SYLVANIA AVE STE A",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436233372",
            "telephone_number": "419-471-0400",
            "fax_number": "419-471-0403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOOP FAMILY PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A",
        "authorized_official_last_name": "KOOP",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "LEE SHINE",
        "authorized_official_title_or_position": "MEMBER OF LLC",
        "authorized_official_telephone_number": "419-471-0400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "009627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2714094",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard George Konrath, O.D.
• Nathaniel Konzen
• Danielle Koonce
• Sharnita Koonce
• Sarah Koontz, PHARMD
• Douglas P Koop, DPT
• Michelle Lee Shine Koop, DPT
• Kopan Eyecare LLC
• Dean Kopan, O.D,
• Thomas Kopp, M.D.

• Physical Therapist in Toledo, OH
• Providers in Toledo, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; 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.