Koth Therapy & Fitness, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

458R Issued in MD

Legal business name

KOTH THERAPY & FITNESS, LLC

Practice address

30387 Three Notch Road
Charlotte Hall, MD 20622-3183

Phone

(301) 884-0331

Fax

(301) 472-4388

NPI assigned

Mar 1, 2007

Organization subpart

No

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

Authorized official

Name

Christopher R Koth, PTNPI 1508994484

Title

PT

Phone

(301) 884-0331

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christopher Koth, PT

  • Physical Therapist
  • Charlotte Hall, MD
  • NPI 1508994484
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470009600000",
    "number": "1881722775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 398",
            "city": "CHARLOTTE HALL",
            "state": "MD",
            "postal_code": "206220398",
            "telephone_number": "301-884-0331",
            "fax_number": "301-472-4388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30387 THREE NOTCH ROAD",
            "city": "CHARLOTTE HALL",
            "state": "MD",
            "postal_code": "206223183",
            "telephone_number": "301-884-0331",
            "fax_number": "301-472-4388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOTH THERAPY & FITNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2016-08-01",
        "status": "A",
        "authorized_official_last_name": "KOTH",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PT",
        "authorized_official_telephone_number": "301-884-0331",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "458R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "LN18KO",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2938436",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Jolly
• Aileen Kim, MD
• Dana Kim, DMD
• Hae Sook Kim, D M D
• Jemill Hester Kollore, TRAINEE STATUS
• Christopher Koth, PT
• Mary Kramer
• Michael Kruepke
• Mackensey Kubina, LGSW
• Lizabeth Lenhart-Cooksey, LCSW-C, LCADC

• Physical Therapist in Charlotte Hall, MD
• Providers in Charlotte Hall, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.