Individual provider Active NPI

Jennifer Kruit

  • Physical Therapist
  • Fort Wayne, IN
National Provider Identifier
1558839571
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05013203A Issued in IN
Practice address
9426 Lima Rd Ste a
Fort Wayne, IN 46818-8681
Phone
(260) 497-0328
NPI assigned
Nov 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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 05013203A IN Primary

Addresses

Primary practice location

9426 Lima Rd Ste a
Fort Wayne, IN 46818-8681

Mailing address

12844 Coldwater Rd Ste B
Fort Wayne, IN 46845-8833

Other practice location 1

4025 Sage Bluff Xing
Fort Wayne, IN 46804-2365
Phone (260) 497-7191

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200825002519 IN Practitioner - Physical Therapist in Private Practice 7517384332 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Steppin' Up Physical Therapy, Inc.Group PAC ID 3476516071, 21 clinicians

Practice addresses (Care Compare)

4025 Sage Bluff Xing
Fort Wayne, IN 46804-2365
Phone (260) 497-7191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Health Care Management LLC Physical Therapist CurrentSince Aug 1, 2020 Accepting new patients
Creative Health Care Management LLC Physical Therapist CurrentSince Aug 1, 2020 Accepting new patients
Steppin Up Physical Therapy, Inc. CurrentSince Aug 26, 2021 Accepting new patients
Steppin Up Physical Therapy, Inc. Physical Therapist CurrentSince Aug 26, 2021 Accepting new patients

Locations

300 E Washington Blvd
Fort Wayne, IN 46802
Phone (260) 422-5511

12844 Coldwater Rd
Ste B
Fort Wayne, IN 46845

9823 Auburn Rd
Fort Wayne, IN 46825

7125 Hanna St
Fort Wayne, IN 46816
Phone (260) 249-9818

4025 Sage Bluff Xing
Fort Wayne, IN 46804
Phone (260) 443-3044

3805 S Calhoun St
Fort Wayne, IN 46807
Phone 2604977191201

10 S 9th St
Ste 4
Noblesville, IN 46060

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1558839571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12844 COLDWATER RD STE B",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468458833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9426 LIMA RD STE A",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468188681",
            "telephone_number": "260-497-0328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4025 Sage Bluff Xing",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468042365",
            "country_code": "US",
            "telephone_number": "260-497-7191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRUIT",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-07",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05013203A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.