Individual provider Active NPI

Iwona Krakowiak

  • Physical Therapy Assistant
  • Ellington, CT
National Provider Identifier
1003352527
Registry record updated Jan 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
1672 Issued in CT
Practice address
115 West Rd Apt 1907
Ellington, CT 06029-3786
Phone
(860) 518-8362
NPI assigned
Jan 7, 2017
Last updated
Jan 7, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1672 CT Primary

Addresses

Primary practice location

115 West Rd Apt 1907
Ellington, CT 06029-3786

Mailing address

115 West Rd Apt 1907
Ellington, CT 06029-3786
Phone (860) 518-8362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1672CTMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1483747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483747200000",
    "number": "1003352527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 WEST RD APT 1907",
            "city": "ELLINGTON",
            "state": "CT",
            "postal_code": "060293786",
            "telephone_number": "860-518-8362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 WEST RD APT 1907",
            "city": "ELLINGTON",
            "state": "CT",
            "postal_code": "060293786",
            "telephone_number": "860-518-8362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAKOWIAK",
        "first_name": "IWONA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-07",
        "last_updated": "2017-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CT",
            "license": "1672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.