Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Logan J Koopman, DPT

Individual provider Physical Therapist · NPI 1750906400

Logan J Koopman, DPT is a Physical Therapist in Private Practice in Ballwin, Missouri. Qualified in 2020, 6 years ago. Practices with Axes Physical Therapy LLC, a 113-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Iowa.

Years since qualifying
6
Licensed in
IA
In the registry since
2020
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

14081 Manchester Rd
Ballwin, MO 63011-4513
Phone: (636) 493-8642
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 510 Bank St, Webster City, IA 50595-2204 — (515) 832-8484
  • 600 Oakmont Ln Ste 600c, Westmont, IL 60559-5548 — (630) 575-1980

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 100737 (IA)

Record details

NPI number1750906400
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedJune 9, 2020
Last updated in NPPESSeptember 16, 2024
Certification dateSeptember 16, 2024
Mailing address647 Spirit Airpark West Dr Ste 101, Chesterfield, MO 63005-1032

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Axes Physical Therapy Llc — 113 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Ballwin