Active NPI
Kristina Foster, PT
- Physical Therapist
- Peoria, IL
National Provider Identifier
1710033188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070-015329
- Practice address
- 5009 N Executive Dr Ste B
Peoria, IL 61614 - Phone
- (309) 839-8631
- Fax
- (855) 579-3536
- NPI assigned
- Jan 26, 2007
- Sex
- Female
- 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 | 070-015329 | IL | Primary |
Addresses
Primary practice location
5009 N Executive Dr Ste B
Peoria, IL 61614
Mailing address
5009 N Executive Dr Ste B
Peoria, IL 61614-4866
Phone (309) 839-8631
Other practice location 1
3531 W Willow Knolls Dr
Peoria, IL 61614-1078
Phone (309) 687-3690
Other practice location 2
719 W Lake Ave
Peoria, IL 61614-5941
Phone (309) 839-8631
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070-015329 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Accelerated Rehabilitation Centers LTD | Physical Therapist | Past | Accepting new patients |
| JD Nimrick PC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Physical Therapist
- Westmont, IL
- NPI 1205875713
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532995200000",
"number": "1710033188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5009 N EXECUTIVE DR STE B",
"city": "PEORIA",
"state": "IL",
"postal_code": "616144866",
"telephone_number": "309-839-8631",
"fax_number": "855-579-3536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5009 N EXECUTIVE DR STE B",
"city": "PEORIA",
"state": "IL",
"postal_code": "61614",
"telephone_number": "309-839-8631",
"fax_number": "855-579-3536"
}
],
"practiceLocations": [
{
"address_1": "3531 W Willow Knolls Dr",
"address_purpose": "LOCATION",
"city": "Peoria",
"state": "IL",
"postal_code": "616141078",
"country_code": "US",
"telephone_number": "309-687-3690",
"fax_number": "309-683-6902",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "719 W Lake Ave",
"address_purpose": "LOCATION",
"city": "Peoria",
"state": "IL",
"postal_code": "616145941",
"country_code": "US",
"telephone_number": "309-839-8631",
"fax_number": "855-579-3536",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FOSTER",
"first_name": "KRISTINA",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-26",
"last_updated": "2018-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070-015329",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.