Active NPI
Dakota Taylor Kresge, PTA
- Physical Therapist
- Pittston, PA
National Provider Identifier
1609648872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- TEI005302
- Practice address
- 33 N Main St
Pittston, PA 18640-1949 - Phone
- (570) 208-2787
- Fax
- (570) 208-2788
- NPI assigned
- Oct 23, 2023
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | TEI005302 | PA | Primary |
Addresses
Primary practice location
33 N Main St
Pittston, PA 18640-1949
Mailing address
33 N Main St
Pittston, PA 18640-1949
Phone (570) 208-2787
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 |
|---|---|---|---|
| TEI005302 | PA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RMC PT, LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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": "1698019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698019200000",
"number": "1609648872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 N MAIN ST",
"city": "PITTSTON",
"state": "PA",
"postal_code": "186401949",
"telephone_number": "570-208-2787",
"fax_number": "570-208-2788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 N MAIN ST",
"city": "PITTSTON",
"state": "PA",
"postal_code": "186401949",
"telephone_number": "570-208-2787",
"fax_number": "570-208-2788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRESGE",
"first_name": "DAKOTA",
"middle_name": "TAYLOR",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-10-23",
"last_updated": "2023-10-23",
"certification_date": "2023-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "TEI005302",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pittston, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.