Active NPI
Angela R Krieger, PTA
- Physical Therapy Assistant
- Appleton, WI
National Provider Identifier
1104151992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 1629-19
- Practice address
- 3305 N Ballard Rd Ste C
Appleton, WI 54911-9001 - Phone
- (920) 735-9234
- NPI assigned
- Oct 12, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 1629-19 | WI | Primary |
Addresses
Primary practice location
3305 N Ballard Rd Ste C
Appleton, WI 54911-9001
Mailing address
416 Harrison St
Apt. 6
North Fond Du Lac, WI 54937-1241
Phone (608) 387-9946
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1629-19 | WI | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley-Bay Therapy Inc. | Physical Therapy Assistant | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256601600000",
"number": "1104151992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "416 HARRISON ST",
"address_2": "APT. 6",
"city": "NORTH FOND DU LAC",
"state": "WI",
"postal_code": "549371241",
"telephone_number": "608-387-9946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3305 N BALLARD RD STE C",
"city": "APPLETON",
"state": "WI",
"postal_code": "549119001",
"telephone_number": "920-735-9234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRIEGER",
"first_name": "ANGELA",
"middle_name": "R",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-12",
"last_updated": "2009-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "1629-19",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.