Theodore Michael Koukles, DC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

2301002803 Issued in MI

Practice address

35525 Garfield Rd
Suite B
Clinton TWP, MI 48035-5521

Phone

(586) 477-1800

Fax

(586) 477-1815

NPI assigned

Jun 30, 2005

Last updated

Jun 11, 2019By the provider in NPPES

Sex

Male

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)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Next Generation Chiropractic

  • Chiropractor
  • Sterling Heights, MI
  • NPI 1942954979
  NPD
• Frederick M. Vogel, DC PC

  dba East Detroit Chiropractic Clinic

  • Chiropractor
  • Eastpointe, MI
  • NPI 1477675205
  NPD (past)
• John M Dimasi DC PC

  dba East Detroit Chiropractic Center

  • Chiropractor
  • Clinton Township, MI
  • NPI 1841689767
  NPD (past)

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1649277096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35525 GARFIELD RD",
            "address_2": "SUITE B",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480355521",
            "telephone_number": "586-477-1800",
            "fax_number": "586-477-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35525 GARFIELD RD",
            "address_2": "SUITE B",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480355521",
            "telephone_number": "586-477-1800",
            "fax_number": "586-477-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUKLES",
        "first_name": "THEODORE",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "MI",
            "license": "2301002803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Rose Kost-Cox, LPC
• Suzana Kostic
• Michael James Kostiuk, D.O.
• Sarah Kostusyk
• Ashley Renee Kot
• Julie Ann Kowarsch, PT
• Jessica Kowynia, DMD
• Peter D Kowynia, MD
• Shirlann Victoria Krahulec
• Ryan Christopher Krebs, DO

• Sports Physician Chiropractor in Clinton TWP, MI
• Providers in Clinton TWP, MI by specialty
• Sports Physician Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.