Individual provider Active NPI

Kristin Ann Cooley, PT, MPT

  • Pediatric Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1831589845
Registry record updated Jan 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
35505 Issued in CA
Practice address
4650 W Sunset Blvd
Mailstop #56
Los Angeles, CA 90027-6062
Phone
(323) 361-2118
NPI assigned
Jan 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 35505 CA Primary

Addresses

Primary practice location

4650 W Sunset Blvd
Mailstop #56
Los Angeles, CA 90027-6062

Mailing address

632 6TH St
Hermosa Beach, CA 90254-4701
Phone (678) 596-6420

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
35505CAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1422403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422403200000",
    "number": "1831589845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 6TH ST",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902544701",
            "telephone_number": "678-596-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD",
            "address_2": "MAILSTOP #56",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOLEY",
        "first_name": "KRISTIN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PT, MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-28",
        "last_updated": "2015-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CA",
            "license": "35505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2015; 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.