Active NPI
Kora Ribley, PTA
- Physical Therapy Assistant
- Manitowoc, WI
National Provider Identifier
1700484326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 3075
- Practice address
- 1650 S 41St St
Manitowoc, WI 54220-7316 - Phone
- (920) 320-3131
- Fax
- (920) 320-5114
- NPI assigned
- Oct 15, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 3075 | WI | Primary |
Addresses
Primary practice location
1650 S 41St St
Manitowoc, WI 54220-7316
Mailing address
909 Steiners Corners Rd
Two Rivers, WI 54241-9754
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 390806395 | Medicaid | WI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3075 | WI | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728950400000",
"number": "1700484326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 STEINERS CORNERS RD",
"city": "TWO RIVERS",
"state": "WI",
"postal_code": "542419754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 S 41ST ST",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542207316",
"telephone_number": "920-320-3131",
"fax_number": "920-320-5114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIBLEY",
"first_name": "KORA",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-15",
"last_updated": "2024-10-15",
"certification_date": "2024-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "3075",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "390806395",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manitowoc, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.