Kennedy Jo Kroeckel

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

020493 Issued in OH

Practice address

851 S Clinton St
Defiance, OH 43512-2770

Phone

(419) 785-4415

NPI assigned

May 16, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Defiance Physical Therapy and Sports Medicine, LLCGroup PAC ID 2466696380, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Defiance Physical Therapy and Sports Medicine, LLC

  • Physical Therapist
  • Defiance, OH
  • NPI 1023458270
  Medicare reassignment Care Compare group
• Peters Family Eyecare Associates

  • Optometrist
  • Bryan, OH
  • NPI 1699969030
  NPD (past)

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1366133894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 S CLINTON ST",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435122770",
            "telephone_number": "419-785-4415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 S CLINTON ST",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435122770",
            "telephone_number": "419-785-4415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROECKEL",
        "first_name": "KENNEDY",
        "middle_name": "JO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-16",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "020493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Knuckles, RN
• Danielle Kolb, RN
• Nanette Marie Kopina
• Robert Kramer Jr.
• Megan N Kreischer
• Kroger Limited Partnership I
• Patricia Sheehan Kroncke, RN,CNS,APRN
• Krouse-Evans, Inc.
• Jessica Rose Krugh, PA
• Mark Kuhlman

• Physical Therapist in Defiance, OH
• Providers in Defiance, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; 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.