Individual provider Active NPI

Ann Marie Kreiser, DPT

  • Physical Therapist
  • Peoria, IL
National Provider Identifier
1356035869
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070026490 Issued in IL
Practice address
6501 N Sheridan Rd
Peoria, IL 61614-2932
Phone
(309) 621-4111
Fax
(309) 621-4119
NPI assigned
Jun 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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 070026490 IL Primary

Addresses

Primary practice location

6501 N Sheridan Rd
Peoria, IL 61614-2932

Mailing address

425 N Lawndale Ave
Washington, IL 61571-1647
Phone (815) 228-8546

Other names 1

  • Ann Marie Miller Former name

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

State licenses

LicenseStateTypeSpecialty
070026490ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1686096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1356035869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 N LAWNDALE AVE",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615711647",
            "telephone_number": "815-228-8546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 N SHERIDAN RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616142932",
            "telephone_number": "309-621-4111",
            "fax_number": "309-621-4119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREISER",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-07",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070026490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "MILLER",
            "middle_name": "MARIE",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; 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.