Individual provider Active NPI

Ashley Ann Koehn, PTA

  • Physical Therapy Assistant
  • Fort Wayne, IN
National Provider Identifier
1851598825
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
06003392A Issued in IN
Practice address
3811 Parnell Ave
Fort Wayne, IN 46805-1409
Phone
(260) 482-4651
Fax
(260) 483-9505
NPI assigned
Jul 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 06003392A IN Primary

Addresses

Primary practice location

3811 Parnell Ave
Fort Wayne, IN 46805-1409

Mailing address

1703 Legoma Dr
Fort Wayne, IN 46819-2009
Phone (219) 363-4806

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
06003392AINMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851598825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 LEGOMA DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468192009",
            "telephone_number": "219-363-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 PARNELL AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468051409",
            "telephone_number": "260-482-4651",
            "fax_number": "260-483-9505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEHN",
        "first_name": "ASHLEY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06003392A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • 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.