Coby Thrailkill

Individual provider Active NPI Physical Therapy Assistant · Green Ridge, MO

NPI 1942996848 · NPPES record last updated Dec 8, 2025

Key facts

NPI
1942996848
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2019011918 (MO)
Practice address
104 E Cooper St
Green Ridge, MO 65332-1025
Phone
(660) 988-4902
NPI assigned
Apr 13, 2023
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
CP042840AGAMDPhysical Therapy Assistant
CP022192AIAMDPhysical Therapy Assistant
PT20240095NMMDPhysical Therapy Assistant
CP044036AOKMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Yes Therapy LLC Physical Therapy Assistant Current
since Apr 16, 2023
Accepting new patients

Locations

104 E Cooper St
Green Ridge, MO 65332
Phone (660) 988-4902

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X CP042840A GA
Physical Therapy Assistant 225200000X PT20240095 NM
Physical Therapy Assistant 225200000X CP022192A IA
Physical Therapy Assistant 225200000X 2019011918 MO Yes
Physical Therapy Assistant 225200000X CP044036A OK

Addresses

Primary practice location

104 E Cooper St
Green Ridge, MO 65332-1025

Mailing address

104 E Cooper St
Green Ridge, MO 65332-1025
Phone (660) 988-4902

Other providers in Green Ridge, MO

All providers in Green Ridge, MO · Physical Therapy Assistant in Missouri

Sources for this page

Verify at the official NPI Registry.