Individual provider Active NPI

Timothy J Krochta, BA

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Wilkes Barre, PA
National Provider Identifier
1184840357
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Practice address
Choices Recovery Program
Rear 307 Laird Street
Wilkes-Barre, PA 18702
Phone
(570) 408-9320
NPI assigned
Apr 17, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary

Addresses

Primary practice location

Choices Recovery Program
Rear 307 Laird Street
Wilkes-Barre, PA 18702

Mailing address

67 Elizabeth St
Dallas, PA 18612-1710
Phone (503) 998-4241

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
Credentials
Bachelor of Arts

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184840357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 ELIZABETH ST",
            "city": "DALLAS",
            "state": "PA",
            "postal_code": "186121710",
            "telephone_number": "503-998-4241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CHOICES RECOVERY PROGRAM",
            "address_2": "REAR 307 LAIRD STREET",
            "city": "WILKES-BARRE",
            "state": "PA",
            "postal_code": "18702",
            "telephone_number": "570-408-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROCHTA",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "BA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.