Individual provider Active NPI

Drew C Koetter, DPT

  • Physical Therapist
  • Wichita Falls, TX
National Provider Identifier
1386082402
Registry record updated Jun 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3113897 Issued in TX
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

Updated by the provider on Jun 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
111408402MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3113897TXMDPhysical 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.

Verify at the official NPI Registry.