Active NPI
Chad Ryan Kruse, PT, DPT
- Physical Therapist
- San Antonio, TX
National Provider Identifier
1386255800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1335551
- Practice address
- 11919 Culebra Road
BLDG. 1, Suite 101
San Antonio, TX 78253 - Phone
- (210) 828-7557
- Fax
- (210) 828-7756
- NPI assigned
- Aug 10, 2020
- Last updated
- Aug 10, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1335551 | TX | Primary |
Addresses
Primary practice location
11919 Culebra Road
BLDG. 1, Suite 101
San Antonio, TX 78253
Mailing address
11919 Culebra Road
BLDG. 1, Suite 101
San Antonio, TX 78253
Phone (210) 828-7557
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1335551 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597017600000",
"number": "1386255800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11919 CULEBRA ROAD",
"address_2": "BLDG. 1, SUITE 101",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78253",
"telephone_number": "210-828-7557",
"fax_number": "210-828-7756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11919 CULEBRA ROAD",
"address_2": "BLDG. 1, SUITE 101",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78253",
"telephone_number": "210-828-7557",
"fax_number": "210-828-7756"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUSE",
"first_name": "CHAD",
"middle_name": "RYAN",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-10",
"last_updated": "2020-08-10",
"certification_date": "2020-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1335551",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.