Mark Kolb, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA 20708 Issued in FL

Practice address

1525 Herbert St Ste 103
Port Orange, FL 32129-6107

Phone

(386) 756-0424

Fax

(386) 756-0425

NPI assigned

Feb 6, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Cora Health Services Inc

  dba CORA Physical Therapy - Port Orange

  • Rehabilitation Clinic/Center
  • Port Orange, FL
  • NPI 1275562845
  NPD (past)
• Cora Health Services, Inc

  dba CORA Physical Therapy-Stoneybrook

  • Rehabilitation Clinic/Center
  • Winter Garden, FL
  • NPI 1104786805
  NPD (past)

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780723510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3453 COUNTRY WALK DR",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321293156",
            "telephone_number": "386-299-7427",
            "fax_number": "386-756-0425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 HERBERT ST STE 103",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321296107",
            "telephone_number": "386-756-0424",
            "fax_number": "386-756-0425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLB",
        "first_name": "MARK",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA 20708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST ASSIST",
            "identifier": "PTA 20708",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret Klintworth
• Laura Knepple
• Alejandro Knight, CRNA
• Melissa Koch
• Allyssa Nicole Koerber, PA-C
• Glenda Kollm, BSN
• Ramneet Kooner, MD
• Brooke Koontz, MS
• Adam Kornecki, LMT
• Christian A Kovats, DO

• Physical Therapy Assistant in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.