Individual provider Active NPI

Krista Lynn Smucker, DPT

  • Physical Therapist
  • Millersburg, PA
National Provider Identifier
1326433426
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT024237 Issued in PA
Practice address
100 S First Street
Ste B
Millersburg, PA 17061-1501
Phone
(717) 692-4708
Fax
(717) 692-5464
NPI assigned
Apr 6, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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 PT024237 PA Primary

Addresses

Primary practice location

100 S First Street
Ste B
Millersburg, PA 17061-1501

Mailing address

7 Dock Hill Rd
Middleburg, PA 17842-8910
Phone (570) 837-2123

Other identifiers 3

IdentifierTypeStateIssuer
1035884330001MedicaidPA
1035884330002MedicaidPA
842014OtherPAMEDICARE

Other names 1

  • Krista Lynn Shenk Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190823000594 PA Practitioner - Physical Therapist in Private Practice 1355679788 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT024237PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Practice Center, PC Physical Therapist CurrentSince Jul 7, 2019 Accepting new patients
Family Practice Center, PC CurrentSince Jul 7, 2019 Accepting new patients

Locations

836 Houston Run Dr
Ste 101
Gap, PA 17527
Phone (717) 442-8957

7 Dock Hill Rd
Middleburg, PA 17842
Phone (570) 837-2123

100 1st St
Millersburg, PA 17061
Phone (717) 692-4834

100 1st St
Ste B
Millersburg, PA 17061
Phone (717) 692-4708

75 Evelyn Dr
Millersburg, PA 17061
Phone (717) 692-4708

100 Historic Dr
Strasburg, PA 17579
Phone (717) 687-6657

Organizations & group practices 2

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": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1326433426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 DOCK HILL RD",
            "city": "MIDDLEBURG",
            "state": "PA",
            "postal_code": "178428910",
            "telephone_number": "570-837-2123",
            "fax_number": "570-837-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S FIRST STREET",
            "address_2": "STE B",
            "city": "MILLERSBURG",
            "state": "PA",
            "postal_code": "170611501",
            "telephone_number": "717-692-4708",
            "fax_number": "717-692-5464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMUCKER",
        "first_name": "KRISTA",
        "middle_name": "LYNN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-06",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT024237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1035884330001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1035884330002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "842014",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTA",
            "last_name": "SHENK",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Millersburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.