Active NPI
Drew C Koetter, DPT
- Physical Therapist
- Wichita Falls, TX
National Provider Identifier
1386082402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3113897
- Practice address
- 1005 Midwestern Pkwy
Wichita Falls, TX 76302-2211 - Phone
- (940) 322-0771
- Fax
- (940) 766-4943
- NPI assigned
- Jun 11, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3113897 | TX | Primary |
Addresses
Primary practice location
1005 Midwestern Pkwy
Wichita Falls, TX 76302-2211
Mailing address
1005 Midwestern Pkwy
Wichita Falls, TX 76302-2211
Phone (940) 322-0771
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 111408402 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 86.32 of 100
- Quality
- 84.44
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 70.78
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3113897 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370908800000",
"number": "1386082402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1005 MIDWESTERN PKWY",
"city": "WICHITA FALLS",
"state": "TX",
"postal_code": "763022211",
"telephone_number": "940-322-0771",
"fax_number": "940-766-4943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 MIDWESTERN PKWY",
"city": "WICHITA FALLS",
"state": "TX",
"postal_code": "763022211",
"telephone_number": "940-322-0771",
"fax_number": "940-766-4943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOETTER",
"first_name": "DREW",
"middle_name": "C",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-06-11",
"last_updated": "2013-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "3113897",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "111408402",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wichita Falls, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.