Active NPI
Theodore K Krutky, M.D.
- Internal Medicine Physician
- Cuyahoga Falls, OH
National Provider Identifier
1609841964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 35039773
- Practice address
- 802 Graham Rd
Cuyahoga Falls, OH 44221-1049 - Phone
- (330) 929-4221
- Fax
- (330) 929-7513
- NPI assigned
- Feb 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35039773 | OH | Primary |
Addresses
Primary practice location
802 Graham Rd
Cuyahoga Falls, OH 44221-1049
Mailing address
PO Box 26125
Akron, OH 44319-6125
Phone (888) 719-9020
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 729848 | Other | OH | BUCKEYE COMMUNITY HEALTH |
| Q013420 | Other | OH | HOMETOWN HEALTH PLAN |
| 0340867 | Medicaid | OH | |
| 000000129127 | Other | OH | ANTHEM |
| 791111263 | Other | OH | RAILROAD MEDICARE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247097600000",
"number": "1609841964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 26125",
"city": "AKRON",
"state": "OH",
"postal_code": "443196125",
"telephone_number": "888-719-9020",
"fax_number": "330-493-7123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "802 GRAHAM RD",
"city": "CUYAHOGA FALLS",
"state": "OH",
"postal_code": "442211049",
"telephone_number": "330-929-4221",
"fax_number": "330-929-7513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUTKY",
"first_name": "THEODORE",
"middle_name": "K",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-21",
"last_updated": "2009-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "35039773",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BUCKEYE COMMUNITY HEALTH",
"identifier": "729848",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HOMETOWN HEALTH PLAN",
"identifier": "Q013420",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0340867",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000129127",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "791111263",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cuyahoga Falls, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.