Individual provider Active NPI

Jessica Krotzer

  • Physical Therapy Assistant
  • Dallas, TX
National Provider Identifier
1487014940
Registry record updated Feb 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
4402 Issued in ID
Practice address
1755 Wittington PL
Suite #175
Dallas, TX 75234-1927
Phone
(866) 221-5405
NPI assigned
Feb 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2016

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 4402 ID Primary
Physical Therapy Assistant 225200000X 1078 ND
Physical Therapy Assistant 225200000X 2561 OK
Physical Therapy Assistant 225200000X 2088830 TX
Physical Therapy Assistant 225200000X 2306602700 VA

Addresses

Primary practice location

1755 Wittington PL
Suite #175
Dallas, TX 75234-1927

Mailing address

1994 Carter Rd
Midland, MI 48642-9272

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4402IDMDPhysical Therapy Assistant
2088830TXMDPhysical Therapy Assistant
2306602700VAMDPhysical Therapy Assistant
2561OKMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456444800000",
    "number": "1487014940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1994 CARTER RD",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486429272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 WITTINGTON PL",
            "address_2": "SUITE #175",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752341927",
            "telephone_number": "866-221-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROTZER",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-26",
        "last_updated": "2016-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ID",
            "license": "4402",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ND",
            "license": "1078",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "2561",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2088830",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306602700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2016; 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.