Individual provider Active NPI

Laureen Katherine Krakowski, PTA

  • Physical Therapy Assistant
  • Brunswick, GA
National Provider Identifier
1598995474
Registry record updated Jul 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA002390 Issued in GA
Practice address
212 Fancy Bluff Cir
Brunswick, GA 31523-6307
Phone
(912) 996-9045
NPI assigned
Jul 25, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA002390 GA Primary

Addresses

Primary practice location

212 Fancy Bluff Cir
Brunswick, GA 31523-6307

Mailing address

212 Fancy Bluff Cir
Brunswick, GA 31523-6307
Phone (912) 996-5443

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
PTA002390GAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1248480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248480000000",
    "number": "1598995474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 FANCY BLUFF CIR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315236307",
            "telephone_number": "912-996-5443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 FANCY BLUFF CIR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315236307",
            "telephone_number": "912-996-9045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAKOWSKI",
        "first_name": "LAUREEN",
        "middle_name": "KATHERINE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-25",
        "last_updated": "2009-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA002390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2009; 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.