Mara M Kruse

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2024004708 Issued in MO

Practice address

17331 E 40 Hwy Ste 105
Independence, MO 64055-6444

Phone

(816) 478-2333

NPI assigned

Feb 14, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1707868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723939200000",
    "number": "1366207854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13001 E BETH LEE DR",
            "city": "PECULIAR",
            "state": "MO",
            "postal_code": "640789456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17331 E 40 HWY STE 105",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640556444",
            "telephone_number": "816-478-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "MARA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-14",
        "last_updated": "2024-08-18",
        "certification_date": "2024-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-07559",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2024004708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carmen Emily Kowalski, DPT
• Logan Frederick Kratt, MD
• Curt A Krause, D.C.
• Kris Chiropractic
• Rohit Krishna, MD
• Tracie Janeann Krysa
• Olga Kulbatskaya
• Wendy Kullberg, DPT
• Amit Kumar, DDS
• Pratyush Kumar, M.D.

• Physical Therapist in Independence, MO
• Providers in Independence, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2024; 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.