Individual provider Active NPI

Krystal Place, DPT

  • Physical Therapist
  • Chattanooga, TN
National Provider Identifier
1649897646
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12775 Issued in TN
Practice address
1201 Market St Ste a
Chattanooga, TN 37402-2714
Phone
(423) 648-4490
Fax
(423) 648-4491
NPI assigned
Jun 25, 2020
Last updated
Mar 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 12775 TN Primary

Addresses

Primary practice location

1201 Market St Ste a
Chattanooga, TN 37402-2714

Mailing address

1201 Market St Ste a
Chattanooga, TN 37402-2714
Phone (423) 648-4490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200807003023 TN Practitioner - Physical Therapist in Private Practice 7517382427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Chattanooga Physical TherapyGroup PAC ID 8022256130, 4 clinicians

Practice addresses (Care Compare)

1201 Market St
Suite a
Chattanooga, TN 37402-2714
Phone (423) 648-4490

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chattanooga Physical Therapy CurrentSince Feb 17, 2022 Accepting new patients

Locations

1201 Market St
#A
Chattanooga, TN 37402
Phone (423) 648-4490

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1593043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1649897646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 MARKET ST STE A",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374022714",
            "telephone_number": "423-648-4490",
            "fax_number": "423-648-4491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 MARKET ST STE A",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374022714",
            "telephone_number": "423-648-4490",
            "fax_number": "423-648-4491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLACE",
        "first_name": "KRYSTAL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-25",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "12775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.