Koala Sports Medicine Centers LP

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

KOALA SPORTS MEDICINE CENTERS LP

Practice address

1007 S Congress Ave
B11
Austin, TX 78704-8707

Phone

(512) 326-5333

NPI assigned

Mar 2, 2007

Last updated

Aug 22, 2020By 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

Ed Kieke, D.C.

Title

President

Phone

(713) 652-9777

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Patrick S Fabacher, D.C.

  • Chiropractor
  • Austin, TX
  • NPI 1760778211
  NPD (past)
• Donald Nguyen, PT

  • Physical Therapist
  • Austin, TX
  • NPI 1558552208
  NPD (past)

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326177858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 890389",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772890389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 S CONGRESS AVE",
            "address_2": "B11",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787048707",
            "telephone_number": "512-326-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOALA SPORTS MEDICINE CENTERS LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIEKE",
        "authorized_official_first_name": "ED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-652-9777",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP ID #",
            "identifier": "0022KU",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa P Knutson, MPT
• Tanja Knutson, IBCLC
• Ko Counseling
• Gina Ko
• Heekyung Ko, LPC, LMFT-ASSOCIATE
• Emily Kobayashi
• Dania Kobeissi
• Annamarisa Koch
• Hannah Rachel Koch
• James E. Koch, PA

• Chiropractor in Austin, TX
• Providers in Austin, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.