Kristin Klassa, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1510-19 Issued in WI

Practice address

225 Memorial Dr
Berlin, WI 54923-1243

Phone

(920) 361-5534

NPI assigned

Nov 23, 2011

Last updated

Nov 23, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kristin Swansby Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1322006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322006400000",
    "number": "1649547357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 MEMORIAL DR",
            "city": "BERLIN",
            "state": "WI",
            "postal_code": "549231243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 MEMORIAL DR",
            "city": "BERLIN",
            "state": "WI",
            "postal_code": "549231243",
            "telephone_number": "920-361-5534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLASSA",
        "first_name": "KRISTIN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-23",
        "last_updated": "2011-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "1510-19",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE ST OF WISCONSIN",
            "identifier": "1510-19",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "SWANSBY",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David Earl Johanknecht, OD
• Melissa A Johnston, LAT, CEAS, CFCE
• David R Jones, MD
• Dale E Kanak, RPH
• Philip A Keith, M.D.
• Diane Marie Klika, PT
• Benjamin John Kozloski, CRNA
• Keith Anthony Krause, CRNA
• Stephanie Krause, PA
• Danielle Lynn Krueger, RD

• Physical Therapy Assistant in Berlin, WI
• Providers in Berlin, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; 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.