Individual provider Active NPI

Kryste Haas, OTR

  • Occupational Therapist
  • Greeley, CO
National Provider Identifier
1528149119
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
978694 Issued in CO
Practice address
2780 28TH Ave
Greeley, CO 80634-7803
Phone
(970) 339-0011
Fax
(970) 339-0033
NPI assigned
Oct 18, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 978694 CO Primary

Addresses

Primary practice location

2780 28TH Ave
Greeley, CO 80634-7803

Mailing address

2780 28TH Ave
Greeley, CO 80634-7803
Phone (970) 339-0011

Other identifiers 1

IdentifierTypeStateIssuer
94875235MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150731016417 CO Practitioner - Occupational Therapist in Private Practice 8820302029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

6767 29TH St
Greeley, CO 80634-5474
Phone (970) 224-3636

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
978694COMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Oct 25, 2021 Accepting new patients
Poudre Valley Medical Group, LLC Occupational Therapist CurrentSince Oct 25, 2021 Accepting new patients
Poudre Valley Medical Group, LLC PastSince Aug 1, 2020 Accepting new patients

Locations

1900 16th St
Greeley, CO 80631
Phone (970) 350-2438

6767 29th St
Greeley, CO 80634
Phone (970) 652-2000

6767 29th St
Fl 1
Greeley, CO 80634
Phone (970) 652-2477

1605 Foxtrail Dr
Loveland, CO 80538
Phone (970) 672-8875

1605 Foxtrail Dr
Unit 100
Loveland, CO 80538
Phone (970) 674-6514

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528149119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 28TH AVE",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806347803",
            "telephone_number": "970-339-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 28TH AVE",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806347803",
            "telephone_number": "970-339-0011",
            "fax_number": "970-339-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAS",
        "first_name": "KRYSTE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "978694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "94875235",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.