Kitrina Roberts Cooper

Key facts

NPI

1700224722

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapy Assistant 225200000X

License

9544APTA (AZ)

Practice address

2150 Silver Creek Rd
Bullhead City, AZ 86442-8472

Phone

(928) 763-8700

NPI assigned

Jun 12, 2013

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 12, 2013.

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1700224722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 LAKELAND DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864033759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 SILVER CREEK RD",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864428472",
            "telephone_number": "928-763-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS COOPER",
        "first_name": "KITRINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "9544APTA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Bullhead City, AZ · Physical Therapy Assistant in Arizona