Active NPI
Christina Marie Koreerat, DPT
- Physical Therapist
- Fort Meade, MD
National Provider Identifier
1932484433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTL 11461
- Practice address
- 2480 Llewellyn Ave
Fort Meade, MD 20755-7081 - Phone
- (301) 677-8941
- NPI assigned
- Oct 15, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTL 11461 | CO | Primary |
Addresses
Primary practice location
2480 Llewellyn Ave
Fort Meade, MD 20755-7081
Mailing address
1061 Harmon Ave
Fort Stewart, GA 31314-5674
Phone (912) 435-6780
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
| License | State | Type | Specialty |
|---|---|---|---|
| PTL 11461 | CO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721347200000",
"number": "1932484433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1061 HARMON AVE",
"city": "FORT STEWART",
"state": "GA",
"postal_code": "313145674",
"telephone_number": "912-435-6780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2480 LLEWELLYN AVE",
"city": "FORT MEADE",
"state": "MD",
"postal_code": "207557081",
"telephone_number": "301-677-8941"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOREERAT",
"first_name": "CHRISTINA",
"middle_name": "MARIE",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-15",
"last_updated": "2024-07-19",
"certification_date": "2024-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "PTL 11461",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Meade, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.