Blake Coughenour
NPI 1124874375ActiveIndividual· Physical Therapist· Waukee, IA
Physical Therapist with Athletico Ltd, practicing in Waukee, Iowa. Medicare paid $14,795 for services to 95 patients in 2024.
Overview
| NPI | 1124874375 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Apr 29, 2024 |
| Last updated in NPPES | May 28, 2024 |
| Certified by provider | May 28, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 124144 | IA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (IA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 95 |
|---|---|
| Services billed | 699 across 15 procedure codes |
| Paid by Medicare | $14,795 |
Education and affiliations
| Graduation year | 2024 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Athletico LtdOttawa, IL · 2,200 clinicians
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All 44 physical therapists in Waukee · All physical therapists in Iowa