Christopher Koth, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

19020 Issued in MD

Practice address

30387 Three Notch Road
Charlotte Hall
Charlotte Hall, MD 20622-3183

Phone

(301) 884-0331

Fax

(301) 472-4388

NPI assigned

Mar 1, 2007

Sex

Male

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 4

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Koth Therapy & Fitness, LLC

  • Physical Therapist
  • Charlotte Hall, MD
  • NPI 1881722775
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225238400000",
    "number": "1508994484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 398",
            "address_2": "CHARLOTTE HALL",
            "city": "CHARLOTTE HALL",
            "state": "MD",
            "postal_code": "206220398",
            "telephone_number": "301-884-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30387 THREE NOTCH ROAD",
            "address_2": "CHARLOTTE HALL",
            "city": "CHARLOTTE HALL",
            "state": "MD",
            "postal_code": "206223183",
            "telephone_number": "301-884-0331",
            "fax_number": "301-472-4388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTH",
        "first_name": "CHRISTOPHER",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2008-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "19020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "60728701",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "403877100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BCBS",
            "identifier": "4380001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7261400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aileen Kim, MD
• Dana Kim, DMD
• Hae Sook Kim, D M D
• Jemill Hester Kollore, TRAINEE STATUS
• Koth Therapy & Fitness, LLC
• Mary Kramer
• Michael Kruepke
• Mackensey Kubina, LGSW
• Lizabeth Lenhart-Cooksey, LCSW-C, LCADC
• Jordan Licurgo, ADT

• Physical Therapist in Charlotte Hall, MD
• Providers in Charlotte Hall, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.