Debra G Koon, PT,ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1087 Issued in AL

Practice address

15631 Quail PT
Northport, AL 35475-2614

Phone

(205) 349-0995

Fax

(205) 349-0995

NPI assigned

May 11, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advance Pediatric & Adult Therapy,LLC.

  • Physical Therapist
  • Northport, AL
  • NPI 1053528869
  NPD (past) Authorized official

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1386859452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20429",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354020429",
            "telephone_number": "205-349-0995",
            "fax_number": "205-349-0995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15631 QUAIL PT",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354752614",
            "telephone_number": "205-349-0995",
            "fax_number": "205-349-0995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOON",
        "first_name": "DEBRA",
        "middle_name": "G",
        "name_prefix": "Ms.",
        "credential": "PT,ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "1087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD AL",
            "identifier": "51076565",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTH CARE",
            "identifier": "6410032",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryan R. King, MD, PHD
• Evan Brock Kirby
• Krista Klemm
• Emma Kathryn Knight, DDS
• Kenneth M Knight, DC
• Kyung Ook Yoon, MD., PC
• Aaron Mark Ladner, PHARMD
• Haley Brooke Landolt, M.S., ALC
• Landreth & Associates Inc (Tuscaloosa Eye Care)
• Steven R Landreth, OD

• Physical Therapist in Northport, AL
• Providers in Northport, AL by specialty
• Physical Therapist in Alabama

• 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.