Kristine L. Waffle, MS, PT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

05002143A Issued in IN

Practice address

827 Upland Ridge Dr
Fort Wayne, IN 46825-2286

Phone

(260) 341-0294

Fax

(260) 489-8329

NPI assigned

Jun 2, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212364800000",
    "number": "1073772315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "827 UPLAND RIDGE DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468252286",
            "telephone_number": "260-341-0294",
            "fax_number": "260-489-8329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 UPLAND RIDGE DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468252286",
            "telephone_number": "260-341-0294",
            "fax_number": "260-489-8329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAFFLE",
        "first_name": "KRISTINE",
        "middle_name": "L.",
        "credential": "MS, PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2008-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "IN",
            "license": "05002143A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naga Malleswari Vutukuri, MD
• Grace Wachenschwanz, OTD, OTR/L
• Kyler Wade
• Nicole Lynn Vesta Wade
• Sylvia Wade, MS ED.
• Logan Waggoner, BCBA
• Logan Mitchell Wagler
• Amber Wagley
• Jonathan Wagley
• Mary E. Wagmeister, ANP

• Pediatric Physical Therapist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Pediatric Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; 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.