Individual provider Active NPI

Micah Kohlwey, DPT

  • Physical Therapist
  • Lincoln, NE
National Provider Identifier
1306538863
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4528 Issued in NE
Practice address
5401 South St
Lincoln, NE 68506-2150
Phone
(402) 413-3900
NPI assigned
May 23, 2023
Last updated
Oct 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 101422 IA
Physical Therapist 225100000X 4528 NE Primary

Addresses

Primary practice location

5401 South St
Lincoln, NE 68506-2150

Mailing address

1901 W Big Sky Rd
Lincoln, NE 68521-1317
Phone (402) 641-1451

Other practice location 1

1622 Walnut St
Syracuse, NE 68446-7017
Phone (402) 641-1451

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240921000490 NE Practitioner - Physical Therapist in Private Practice 4284175985 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

7030 NW 14TH St
Lincoln, NE 68521-4583

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4528NEMDProfessional Counselor
101422IAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Physiotherapy LLC Physical Therapist CurrentSince Jul 3, 2025 Accepting new patients
Select Rehabilitation, LLC Physical Therapist CurrentSince Sep 16, 2024 Accepting new patients
Pando Geriatric Counseling, PC Past Accepting new patients

Locations

5601 S 84th St
Lincoln, NE 68516
Phone (402) 480-0250

6991 S 178th Plz
Omaha, NE 68136
Phone (402) 819-0669

4801 N 52nd St
Omaha, NE 68104
Phone (402) 557-6860

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1306538863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 W BIG SKY RD",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685211317",
            "telephone_number": "402-641-1451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 SOUTH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062150",
            "telephone_number": "402-413-3900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1622 Walnut St",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NE",
            "postal_code": "684467017",
            "country_code": "US",
            "telephone_number": "402-641-1451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOHLWEY",
        "first_name": "MICAH",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-23",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "101422",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "4528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.