Nicole Annmarie Kotaska

Primary specialty

MechanotherapistTaxonomy code 172M00000X

License

301 Issued in MN

Practice address

3220 Bridge St NW
#111
Saint Francis, MN 55070-8632

Phone

(612) 240-6601

NPI assigned

Dec 7, 2011

Last updated

Dec 7, 2011By the provider in NPPES

Sex

Female

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)

Not enrolled

Practice roles

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.

• Physical Therapy Consultants, Inc.

  dba Ham Lake Physical Therapy

  • Physical Therapy Clinic/Center
  • Ham Lake, MN
  • NPI 1366460719
  NPD (past)

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

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1700154689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4429 231ST CT NW",
            "city": "SAINT FRANCIS",
            "state": "MN",
            "postal_code": "550708788",
            "telephone_number": "612-240-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 BRIDGE ST NW",
            "address_2": "#111",
            "city": "SAINT FRANCIS",
            "state": "MN",
            "postal_code": "550708632",
            "telephone_number": "612-240-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTASKA",
        "first_name": "NICOLE",
        "middle_name": "ANNMARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-07",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "MN",
            "license": "301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Ann Johnson, PHARMD, RPH
• Timothy Mark Johnson, DDS
• Natalie Justin, LGSW
• Jacqueline Jeanne Karpe
• Andrea Knapp
• Arianna Lee Larson, DPT
• Michael Jerome Leadens, LADC
• Gregory Michael McDonnell, DC
• Matthew McGraw Meier
• Sophie Mills, DC

• Mechanotherapist in Saint Francis, MN
• Providers in Saint Francis, MN by specialty
• Mechanotherapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; 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.