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NPI Code Detail

MEDICARE: RYLIE BLAINE SHOOP COTA

MEDICARE: RYLIE BLAINE SHOOP COTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant18-01676KS

General Provider Information

NPI Number : 1437027331
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYLIE BLAINE SHOOP COTA
Provider Business Mailing Address
First Line : 5550 COLONY CT
Second Line :
City : BARTLESVILLE
State : OK
Zip : 74006-8869
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2921 W 1ST ST
Second Line :
City : COFFEYVILLE
State : KS
Zip : 67337-2441
Country : US
Telephone Number : 620-251-3705
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2025
Last Update Date : 10/23/2025

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Directions to “ RYLIE BLAINE SHOOP COTA” Practice Location

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