Michelle R Koerner, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05013053A Issued in IN

Practice address

1114 E Commercial Ave
Lowell, IN 46356-2359

Phone

(219) 690-1048

Fax

(219) 690-1047

NPI assigned

Apr 26, 2018

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 names 1

• Michelle R Dykstra Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

81.34 of 100Reported as group

Quality

57.41

Promoting interoperability

100

Improvement activities

40

Cost

80.4

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Gold Country Therapies, Inc

  • Physical Therapy Clinic/Center
  • Valley Springs, CA
  • NPI 1447658067
  NPD (past)

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

{
    "created_epoch": "1524700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1417445321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 OAKMONT LN STE 600C",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595548",
            "telephone_number": "630-575-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 E COMMERCIAL AVE",
            "city": "LOWELL",
            "state": "IN",
            "postal_code": "463562359",
            "telephone_number": "219-690-1048",
            "fax_number": "219-690-1047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1076 Ribaut Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Beaufort",
            "state": "SC",
            "postal_code": "299025490",
            "country_code": "US",
            "telephone_number": "843-525-0045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOERNER",
        "first_name": "MICHELLE",
        "middle_name": "R",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-26",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05013053A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "DYKSTRA",
            "middle_name": "R",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Lynn Johnson, OD
• Kevin Johnson, OD
• Allie Jordann Karras, RBT
• Nikola Ilija Katic
• Lora A Klompmaker, MSW, LSW
• Nicholas Kouri, DDS
• Anne Marie Kramer, RPH
• Amanda Lange
• Leah Thomas DDS LLC
• Levin Home Health Inc

• All providers in Lowell, IN
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.