Audrey Koller, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2206 Issued in WI

Practice address

106 S Holmen Dr
Suite 2
Holmen, WI 54636-9467

Phone

(608) 526-9888

NPI assigned

Aug 11, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470873600000",
    "number": "1497209001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 10TH AVE S",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546503069",
            "telephone_number": "608-764-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 S HOLMEN DR",
            "address_2": "SUITE 2",
            "city": "HOLMEN",
            "state": "WI",
            "postal_code": "546369467",
            "telephone_number": "608-526-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLER",
        "first_name": "AUDREY",
        "name_prefix": "Miss",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-11",
        "last_updated": "2016-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "2206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karl J Kerr, LMT
• Zoe Kimball
• Jennifer C Klonecki, RN
• Leila Diane Koehler
• Tiphany Louise Kokott, RN
• Jeffrey G Komay, PTA
• Crystal Lee Komp, CNM
• Jennifer Koop, RN
• Michelle Rae Krug, OTR/L
• Madelyn Anne Kuck

• Physical Therapy Assistant in Holmen, WI
• Providers in Holmen, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2016; 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.