Krystal Lynne Ackermann, PT
Individual provider Active NPI Physical Therapist · Grapevine, TX
NPI 1194074740 · NPPES record last updated Aug 20, 2014
Key facts
- NPI
- 1194074740
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1217600 (TX)
- Practice address
- 2535 Ira E Woods Ave
Grapevine, TX 76051-3930 - Phone
- (817) 481-2121
- Fax
- (817) 488-4493
- NPI assigned
- Aug 29, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Joseph Daniels DO
Practice addresses (Care Compare)
6311 Southwest Blvd
Benbrook, TX 76132-1063
Phone (817) 731-9400
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220523000027 | TX | Practitioner - Physical Therapist in Private Practice | 1658758180 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Joseph Daniels, DO | Current |
Accepting new patients | |
| Joseph Daniels, DO | Current |
Accepting new patients |
Locations
6311 Southwest Blvd
Benbrook, TX 76132
Phone (817) 731-9400
Interoperability endpoints
- krystal.ackermann.1@20617.direct.athenahealth.com
- https://api.platform.athenahealth.com/20617/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1217600 | TX | Yes |
Addresses
Primary practice location
2535 Ira E Woods Ave
Grapevine, TX 76051-3930
Mailing address
2535 Ira E Woods Ave
Grapevine, TX 76051-3930
Phone (817) 481-2121
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1217600 | Other | TX | STATE LICENSE |
Other names
- Kristen Lynne Csuk
Other providers in Grapevine, TX
- Absolutecare Health Services Inc
- Academic Healthplans
- Michelle Accardo
- Accucare Family Medical Center P.a.
- Ashish A Acharya
- Adriana Acosta
- Action Healthcare & Wellness
- Trisha F Adams
- Adapthealth Patient Care Solutions Inc.
- Zoe Adom
All providers in Grapevine, TX · Physical Therapist in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.