Theresa Brooks Kotlar, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

213262 Issued in OH

Practice address

7174 Colonial Place
Ravenna, OH 44266

Phone

(330) 906-3331

NPI assigned

Sep 20, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Ms. Theresa Malion Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1442707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450828800000",
    "number": "1396114302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7174 COLONIAL PLACE",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "44268",
            "telephone_number": "330-906-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7174 COLONIAL PLACE",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "44266",
            "telephone_number": "330-906-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTLAR",
        "first_name": "THERESA",
        "middle_name": "BROOKS",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-20",
        "last_updated": "2015-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "OH",
            "license": "213262",
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "OH",
            "license": "RN213262",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "213262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "MALION",
            "prefix": "MS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chelsea Kolleth
• Constance Kondrich, STNA
• Michael Paul Korpita
• Kim Kost, LISW
• Christopher James Koster, PHARMD
• KP Medical Supply LLC
• Krysta Krause
• Joseph W Kravetz, RN
• Nina Krivonic
• McKala Laird Krsacok

• Registered Nurse in Ravenna, OH
• Providers in Ravenna, OH by specialty
• Registered Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2015; 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.