Catherine Marie Koth, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

381-019 Issued in WI

Practice address

202 W Mohawk Dr
Tomahawk, WI 54487-2215

Phone

(715) 453-7600

Fax

(715) 453-6403

NPI assigned

Nov 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1376614909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 E KING RD",
            "city": "TOMAHAWK",
            "state": "WI",
            "postal_code": "544872004",
            "telephone_number": "715-453-4646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 W MOHAWK DR",
            "city": "TOMAHAWK",
            "state": "WI",
            "postal_code": "544872215",
            "telephone_number": "715-453-7600",
            "fax_number": "715-453-6403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTH",
        "first_name": "CATHERINE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "381-019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40336300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Innate Life LLC
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• R Heidi Jarvis
• William Wayne Jones
• David D Kim, MD
• Carri Kraft, RN
• Mary La Haie, R.PH.
• Roger S Lamoreux, O.D.
• Anthony Lamouria, PC
• Katelyn Jo Larsen, MD

• Physical Therapy Assistant in Tomahawk, WI
• Providers in Tomahawk, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.