Active NPI
Tara Lynn Kohler, PT
- Physical Therapist
- Ypsilanti, MI
National Provider Identifier
1639205123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501010523
- Practice address
- 3145 Clark Rd
Ste 102
Ypsilanti, MI 48197-1120 - Phone
- (734) 528-9760
- Fax
- (734) 528-9761
- NPI assigned
- Feb 26, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501010523 | MI | Primary |
Addresses
Primary practice location
3145 Clark Rd
Ste 102
Ypsilanti, MI 48197-1120
Mailing address
3145 Clark Rd
Ste 106
Ypsilanti, MI 48197-1120
Phone (734) 528-9760
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P09920013 | Other | MI | MEDICARE ID UNSPECIFIED |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263340800000",
"number": "1639205123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3145 CLARK RD",
"address_2": "STE 106",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481971120",
"telephone_number": "734-528-9760",
"fax_number": "734-528-9761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3145 CLARK RD",
"address_2": "STE 102",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481971120",
"telephone_number": "734-528-9760",
"fax_number": "734-528-9761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHLER",
"first_name": "TARA",
"middle_name": "LYNN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-26",
"last_updated": "2010-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501010523",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID UNSPECIFIED",
"identifier": "P09920013",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ypsilanti, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.