Individual provider Active NPI

Julie Ann Koornneef, PT

  • Physical Therapist
  • Lakewood, CO
National Provider Identifier
1689319832
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5412 Issued in CO
Practice address
12791 W Alameda Pkwy
Lakewood, CO 80228-2838
Phone
(303) 237-5700
NPI assigned
May 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2022

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 5412 CO Primary

Addresses

Primary practice location

12791 W Alameda Pkwy
Lakewood, CO 80228-2838

Mailing address

4560 SE International Way Ste 100
Milwaukie, OR 97222-4628
Phone (971) 206-5202

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5412COMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1689319832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 SE INTERNATIONAL WAY STE 100",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972224628",
            "telephone_number": "971-206-5202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12791 W ALAMEDA PKWY",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802282838",
            "telephone_number": "303-237-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOORNNEEF",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-02",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "5412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; 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.