Individual provider Active NPI

Charles Benjamin Kretchek, DPT

  • Physical Therapist
  • Wexford, PA
National Provider Identifier
1477991016
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT022730 Issued in PA
Practice address
7500 Brooktree Rd Ste 300
Wexford, PA 15090-9217
Phone
(877) 827-8246
Fax
(877) 827-8246
NPI assigned
Jun 5, 2013
Last updated
Dec 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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 PT022730 PA Primary

Addresses

Primary practice location

7500 Brooktree Rd Ste 300
Wexford, PA 15090-9217

Mailing address

7500 Brooktree Rd Ste 300
Wexford, PA 15090-9217
Phone (877) 827-8246

Other practice location 1

142 Clearview Cir
Butler, PA 16001-1565
Phone (724) 285-5351

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

LicenseStateTypeSpecialty
PT022730PAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1370390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1477991016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 BROOKTREE RD STE 300",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150909217",
            "telephone_number": "877-827-8246",
            "fax_number": "877-827-8246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 BROOKTREE RD STE 300",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150909217",
            "telephone_number": "877-827-8246",
            "fax_number": "877-827-8246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "142 Clearview Cir",
            "address_purpose": "LOCATION",
            "city": "Butler",
            "state": "PA",
            "postal_code": "160011565",
            "country_code": "US",
            "telephone_number": "724-285-5351",
            "fax_number": "724-285-3780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRETCHEK",
        "first_name": "CHARLES",
        "middle_name": "BENJAMIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-05",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT022730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wexford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.

Verify at the official NPI Registry.