NPIMap

Organization Active NPI

Kraetz Holdings LLC

  • Physical Therapy Clinic/Center
  • Skaneateles, NY
National Provider Identifier
1467991802
Registry record updated Feb 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
029599-1 Issued in NY
Legal business name
KRAETZ HOLDINGS LLC
Practice address
810 W Genesee Street Rd
Skaneateles, NY 13152-9311
Phone
(315) 554-8094
Fax
(315) 291-7048
NPI assigned
Feb 17, 2017
Last updated
Feb 17, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2017

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

Authorized official

Name
Dr. Shelly G Kraetz, DPT, CLTNPI 1619169455
Title
Owner / Clinical Director
Phone
(315) 554-8094

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 029599-1 NY Primary

Addresses

Primary practice location

810 W Genesee Street Rd
Skaneateles, NY 13152-9311

Mailing address

PO Box 611
Skaneateles, NY 13152-0611
Phone (315) 554-8094

Other names 1

  • FYZICAL Therapy & Balance Centers Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1487289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487289600000",
    "number": "1467991802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 611",
            "city": "SKANEATELES",
            "state": "NY",
            "postal_code": "131520611",
            "telephone_number": "315-554-8094",
            "fax_number": "315-291-7048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 W GENESEE STREET RD",
            "city": "SKANEATELES",
            "state": "NY",
            "postal_code": "131529311",
            "telephone_number": "315-554-8094",
            "fax_number": "315-291-7048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRAETZ HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-17",
        "last_updated": "2017-02-17",
        "status": "A",
        "authorized_official_last_name": "KRAETZ",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER / CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "315-554-8094",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT, CLT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "029599-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FYZICAL Therapy & Balance Centers",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Skaneateles, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2017; 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.