Individual provider Active NPI

Krista Coppess, PT

  • Physical Therapist
  • Beavercreek, OH
National Provider Identifier
1689757312
Registry record updated May 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT007559 Issued in OH
Practice address
3817 Colonel Glenn Hwy
Beavercreek, OH 45324
Phone
(937) 427-9200
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X PT007559 OH Primary

Addresses

Primary practice location

3817 Colonel Glenn Hwy
Beavercreek, OH 45324

Mailing address

7591 Tylers Place Blvd
West Chester, OH 45069-6308
Phone (513) 755-6600

Other practice location 1

1498 N Broadway St
Greenville, OH 45331-2454
Phone (937) 548-9495

Other practice location 2

1498 N Broadway St
Greenville, OH 45331-2454
Phone (937) 548-9495

Other identifiers 2

IdentifierTypeStateIssuer
2187155MedicaidOH
AB7360731OtherOHMEDICARE PIN

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
PT007559OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Abc Pediatric Therapy LLC Physical Therapist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1689757312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7591 TYLERS PLACE BLVD",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450696308",
            "telephone_number": "513-755-6600",
            "fax_number": "513-755-3762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3817 COLONEL GLENN HWY",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "45324",
            "telephone_number": "937-427-9200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1498 N Broadway St",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "OH",
            "postal_code": "453312454",
            "country_code": "US",
            "telephone_number": "937-548-9495",
            "fax_number": "937-548-3055",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1498 N Broadway St",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "OH",
            "postal_code": "453312454",
            "country_code": "US",
            "telephone_number": "937-548-9495",
            "fax_number": "937-548-3055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COPPESS",
        "first_name": "KRISTA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT007559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2187155",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "AB7360731",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.