Individual provider Active NPI

Kelly Krafft, PTA

  • Physical Therapy Assistant
  • Kissimmee, FL
National Provider Identifier
1588445688
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
33065 Issued in FL
Practice address
1207 N Central Ave
Kissimmee, FL 34741-4407
Phone
(407) 870-5959
NPI assigned
Oct 13, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2022027290 MO
Physical Therapy Assistant 225200000X 33065 FL Primary

Addresses

Primary practice location

1207 N Central Ave
Kissimmee, FL 34741-4407

Mailing address

808 Delchester LN
Kirkwood, MO 63122-1008
Phone (314) 640-3626

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
33065FLMDPhysical Therapy Assistant
2022027290MOMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1697155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1588445688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 DELCHESTER LN",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631221008",
            "telephone_number": "314-640-3626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 N CENTRAL AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414407",
            "telephone_number": "407-870-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAFFT",
        "first_name": "KELLY",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-13",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2022027290",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "33065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; 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.