Kelly Coultrup, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

2100 Solar Dr Ste 204
Oxnard, CA 93036-2602

Phone

(805) 222-6563

NPI assigned

Nov 28, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Two Trees Physical Therapy and Wellness IncGroup PAC ID 5597915603, 58 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Two Trees Physical Therapy & Wellness Inc

  • Physical Therapist
  • Ventura, CA
  • NPI 1770830325

  CA, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Two Trees Physical Therapy & Wellness Inc

  • Physical Therapist
  • Oxnard, CA
  • NPI 1811514243
  Care Compare group
• Two Trees Physical Therapy & Wellness Inc

  • Physical Therapist
  • Ventura, CA
  • NPI 1205453305
  NPD

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

{
    "created_epoch": "1669593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1992415418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 DEAN DR UNIT 701",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033332",
            "telephone_number": "805-585-7742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 SOLAR DR STE 204",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930362602",
            "telephone_number": "805-222-6563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULTRUP",
        "first_name": "KELLY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-28",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Costco Wholesale Corporation
• Costco Wholesale Corporation
• Costco Wholesale Corporation
• Shayne Cotner
• Cottage Clinical Network, LLC
• Counseling Services for Families and Children
• County of Ventura
• County of Ventura
• County of Ventura
• County of Ventura

• All providers in Oxnard, CA
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.