E Evonne Cooper, PT
Individual provider Active NPI Physical Therapist · Shawnee Mission, KS
NPI 1336249507 · NPPES record last updated May 16, 2014
Key facts
- NPI
- 1336249507
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 11-00492 (KS)
- Practice address
- 10000 W 75TH St
Ste 121
Shawnee Mission, KS 66204-2209 - Phone
- (913) 362-7518
- Fax
- (913) 362-7302
- NPI assigned
- Sep 25, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11-00492 | KS | Yes |
Addresses
Primary practice location
10000 W 75TH St
Ste 121
Shawnee Mission, KS 66204-2209
Mailing address
10000 W 75TH St
Ste 121
Shawnee Mission, KS 66204-2209
Phone (913) 362-7518
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100413670B | Medicaid | KS |
Other providers in Shawnee Mission, KS
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- Maura Conry
- David A. Cooley
- Beth Cooper
- Brad Alan Cosens
- Elisabeth L Cozad
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- Custom Chiropractic Center LLC
All providers in Shawnee Mission, KS · Physical Therapist in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.