Individual provider Active NPI

Tessla Erin Koch

  • Occupational Therapy Assistant
  • Coral Springs, FL
National Provider Identifier
1780022939
Registry record updated Jun 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
A01908 Issued in MD
Practice address
1440 Coral Ridge Dr
Suite 435
Coral Springs, FL 33071-5433
Phone
(800) 568-4733
Fax
(877) 859-7377
NPI assigned
Jun 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X A01908 MD Primary

Addresses

Primary practice location

1440 Coral Ridge Dr
Suite 435
Coral Springs, FL 33071-5433

Mailing address

304 Pumphouse Rd
Evans, GA 30809-5177
Phone (706) 829-2169

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
A01908MDMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370822400000",
    "number": "1780022939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 PUMPHOUSE RD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308095177",
            "telephone_number": "706-829-2169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 CORAL RIDGE DR",
            "address_2": "SUITE 435",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330715433",
            "telephone_number": "800-568-4733",
            "fax_number": "877-859-7377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "TESSLA",
        "middle_name": "ERIN",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-10",
        "last_updated": "2013-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MD",
            "license": "A01908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2013; 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.