Individual provider Active NPI

Taylor D Kraal, DPT

  • Physical Therapist
  • Richland, WA
National Provider Identifier
1275103301
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT61125977 Issued in WA
Practice address
1351 Fowler St Ste 110
Richland, WA 99352-4714
Phone
(509) 942-2574
Fax
(509) 942-2575
NPI assigned
Jun 30, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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 PT61125977 WA Primary

Addresses

Primary practice location

1351 Fowler St Ste 110
Richland, WA 99352-4714

Mailing address

550 Gage Blvd Ste 101
Richland, WA 99352-9532
Phone (509) 942-3627

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210715001656 WA Practitioner - Physical Therapist in Private Practice 6305248121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kadlec Regional Medical CenterGroup PAC ID 9739098617, 402 clinicians

Practice addresses (Care Compare)

1351 Fowler St
Richland, WA 99352-4714
Phone (509) 946-1654

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kadlec Regional Medical Center CurrentSince Jul 7, 2021 Accepting new patients
Kadlec Regional Medical Center CurrentSince Jul 7, 2021 Accepting new patients
Kadlec Regional Medical Center CurrentSince Jul 4, 2021 Accepting new patients

Locations

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

550 Gage Blvd
Ste 101
Richland, WA 99352

1135 Jadwin Ave
Richland, WA 99352
Phone (509) 942-3300

1351 Fowler St
Richland, WA 99352
Phone (509) 942-2660

1351 Fowler St
Ste 110
Richland, WA 99352
Phone (509) 942-2574

Organizations & group practices 3

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": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1275103301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 GAGE BLVD STE 101",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993529532",
            "telephone_number": "509-942-3627",
            "fax_number": "509-627-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 FOWLER ST STE 110",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524714",
            "telephone_number": "509-942-2574",
            "fax_number": "509-942-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAAL",
        "first_name": "TAYLOR",
        "middle_name": "D",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61125977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.