Individual provider Active NPI

Daniel J.R. Kraushaar, PT, CSCS

  • Physical Therapist
  • Atlanta, GA
National Provider Identifier
1225071202
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT008105 Issued in GA
Practice address
59 Executive Park South NE
Suite 1100
Atlanta, GA 30329-2208
Phone
(404) 778-6330
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

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
Physical Therapist 225100000X PT008105 GA Primary

Addresses

Primary practice location

59 Executive Park South NE
Suite 1100
Atlanta, GA 30329-2208

Mailing address

111 N Marietta Pkwy NE
A112
Marietta, GA 30060-1478
Phone (706) 536-7851

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040824000881 GA Practitioner - Physical Therapist in Private Practice 0941101273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emory Physical Therapy, LLCGroup PAC ID 1153382676, 96 clinicians

Practice addresses (Care Compare)

1845 Satellite Blvd
Suite 750
Duluth, GA 30097-4005
Phone (404) 778-6490

1968 Hawks LN NE
Brookhaven, GA 30329-2283
Phone (404) 251-2537

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT008105GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Physical Therapy, LLC Current Accepting new patients
Emory Physical Therapy, LLC CurrentSince Nov 27, 2006 Accepting new patients
Emory Physical Therapy, LLC CurrentSince Nov 27, 2006 Accepting new patients
Emory Physical Therapy, LLC Past Accepting new patients
Gundersen Clinic LTD Past Accepting new patients

Locations

59 Executive Park South NE
Ste 1100
Atlanta, GA 30329
Phone (404) 778-6330

1845 Satellite Blvd
Ste 750
Duluth, GA 30097
Phone (404) 778-6490

Organizations & group practices 5

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225071202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N MARIETTA PKWY NE",
            "address_2": "A112",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601478",
            "telephone_number": "706-536-7851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 EXECUTIVE PARK SOUTH NE",
            "address_2": "SUITE 1100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292208",
            "telephone_number": "404-778-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAUSHAAR",
        "first_name": "DANIEL",
        "middle_name": "J.R.",
        "name_prefix": "Mr.",
        "credential": "PT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT008105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.