Active NPI
Frederick Lee Kracke Jr.
- Professional Counselor
- Birmingham, AL
National Provider Identifier
1508124835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3000
- Practice address
- 2204 Lakeshore Dr
Suite 212
Birmingham, AL 35209-6729 - Phone
- (205) 879-7500
- NPI assigned
- Apr 24, 2012
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3000 | AL | Primary |
Addresses
Primary practice location
2204 Lakeshore Dr
Suite 212
Birmingham, AL 35209-6729
Mailing address
3512 Old Leeds CRST
Mountain BRK, AL 35213-3220
Phone (205) 879-2166
Other names 1
- Mr. Gil Kracke
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3000 | AL | MD | Oral & Maxillofacial Surgery (D.M.D.) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335225600000",
"number": "1508124835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3512 OLD LEEDS CRST",
"city": "MOUNTAIN BRK",
"state": "AL",
"postal_code": "352133220",
"telephone_number": "205-879-2166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2204 LAKESHORE DR",
"address_2": "SUITE 212",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352096729",
"telephone_number": "205-879-7500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRACKE",
"first_name": "FREDERICK",
"middle_name": "LEE",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-24",
"last_updated": "2012-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AL",
"license": "3000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "GIL",
"last_name": "KRACKE",
"prefix": "MR.",
"credential": "MA, MA, LPC",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.