Individual provider Active NPI

Tessa Kothe, PT

  • Physical Therapist
  • Colorado Springs, CO
National Provider Identifier
1457969974
Registry record updated Jul 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL.0016970 Issued in CO
Practice address
5747 N Academy Blvd
Colorado Springs, CO 80918-3684
Phone
(719) 201-4759
Fax
(719) 888-1619
NPI assigned
Jul 21, 2020
Last updated
Jul 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2023

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 PTL.0016970 CO Primary

Addresses

Primary practice location

5747 N Academy Blvd
Colorado Springs, CO 80918-3684

Mailing address

5747 N Academy Blvd
Colorado Springs, CO 80918-3684
Phone (719) 201-4759

Other practice location 1

6150 Stadia Ct
Colorado Springs, CO 80915-2657
Phone (719) 642-8442

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL.0016970COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Physio & Performance, LLC Physical Therapist Current Accepting new patients
Altru Integrated Health, LLC Physical Therapist CurrentSince Jul 23, 2023 Accepting new patients

Locations

5747 N Academy Blvd
Colorado Springs, CO 80918
Phone (719) 201-4759

6150 Stadia Ct
Colorado Springs, CO 80915
Phone (719) 419-8833

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690070400000",
    "number": "1457969974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5747 N ACADEMY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183684",
            "telephone_number": "719-201-4759",
            "fax_number": "719-888-1619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5747 N ACADEMY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183684",
            "telephone_number": "719-201-4759",
            "fax_number": "719-888-1619"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6150 Stadia Ct",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809152657",
            "country_code": "US",
            "telephone_number": "719-642-8442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOTHE",
        "first_name": "TESSA",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-21",
        "last_updated": "2023-07-23",
        "certification_date": "2023-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0016970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2023; 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.