Kimberly A Krupack, DPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

PT015837 Issued in GA

Practice address

400 Adams St Unit B
Vidalia, GA 30474-4817

Phone

(478) 254-0636

NPI assigned

Apr 11, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Chit Chat Pediatric Therapy LLC

  • Speech-Language Pathologist
  • Soperton, GA
  • NPI 1689281032
  NPD (past)

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1154884666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 CHAPMAN LN",
            "city": "LOCK HAVEN",
            "state": "PA",
            "postal_code": "177458389",
            "telephone_number": "570-660-4184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 ADAMS ST UNIT B",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304744817",
            "telephone_number": "478-254-0636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "260 Lions Hill Rd",
            "address_purpose": "LOCATION",
            "city": "State College",
            "state": "PA",
            "postal_code": "168031860",
            "country_code": "US",
            "telephone_number": "814-235-8920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRUPACK",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-11",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "GA",
            "license": "PT015837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen Marie Kerrigan, PA
• Rick L Kimbrel I, D.M.D.
• Archie Thomas Kirkley, PA-C
• Sarah B Kitchens, LPC
• Tosaporn Krasaeath, MD
• Kurt P Hofmann MD LLC
• Mary Lesie Kyzer, PTA
• Jessica Leigh Langenfeld, FNP-C
• Lashonda Monique Lanier-Jenkins, REGISTERED NURSE
• Abbey Lanier, OTR/L

• All providers in Vidalia, GA
• Pediatric Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; 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.