Active NPI
Taiwo Anuoluwapo Kola-Korolo, PT
- Orthopedic Physical Therapist
- Tyler, TX
National Provider Identifier
1942777578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 1244220
- Practice address
- 1814 Roseland Blvd
Tyler, TX 75701-4234 - Phone
- (903) 525-3300
- NPI assigned
- Nov 1, 2018
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 1244220 | TX | Primary |
Addresses
Primary practice location
1814 Roseland Blvd
Tyler, TX 75701-4234
Mailing address
1814 Roseland Blvd
Tyler, TX 75701-4234
Phone (903) 525-3300
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 |
|---|---|---|---|
| 1244220 | TX | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541030400000",
"number": "1942777578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1814 ROSELAND BLVD",
"city": "TYLER",
"state": "TX",
"postal_code": "757014234",
"telephone_number": "903-525-3300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1814 ROSELAND BLVD",
"city": "TYLER",
"state": "TX",
"postal_code": "757014234",
"telephone_number": "903-525-3300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLA-KOROLO",
"first_name": "TAIWO",
"middle_name": "ANUOLUWAPO",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-01",
"last_updated": "2018-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "TX",
"license": "1244220",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.