Koda Physical Therapy and Sports Performance
NPI 1356797542 · Physical Therapy Clinic/Center · Petaluma, CA
Enrolled with Medicare as Part B Supplier - Physical/Occupational Therapy Group in Private Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Koda Physical Therapy and Sports Performance is a Physical Therapy Clinic/Center organization in Petaluma, CA (NPI 1356797542).
Provider details
- NPI number
- 1356797542
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Loren Kimble, Owner(415) 425-5206
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2016-05-06
- Last updated
- 2021-06-10
- Certified
- 2021-06-10
Frequently asked questions
- What is Koda Physical Therapy and Sports Performance's NPI number?
- Koda Physical Therapy and Sports Performance's National Provider Identifier (NPI) is 1356797542, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Koda Physical Therapy and Sports Performance?
- Koda Physical Therapy and Sports Performance is classified in the NPPES registry as Physical Therapy Clinic/Center (Ambulatory Health Care Facilities).
- Where is Koda Physical Therapy and Sports Performance located?
- Koda Physical Therapy and Sports Performance's practice location on file with NPPES is 1600 Corporate Cir, Petaluma, CA 94954-6912.
- What is Koda Physical Therapy and Sports Performance's phone number?
- The practice phone number listed in the NPPES registry for Koda Physical Therapy and Sports Performance is (707) 981-8604.
- Does Koda Physical Therapy and Sports Performance accept Medicare?
- Koda Physical Therapy and Sports Performance is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Koda Physical Therapy and Sports Performance?
- The authorized official listed on Koda Physical Therapy and Sports Performance's NPPES record is Loren Kimble, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Koda Physical Therapy and Sports Performance's NPI active?
- Yes — Koda Physical Therapy and Sports Performance's NPI (1356797542) is active in the NPPES registry as of the last update on 2021-06-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.