Individual provider Active NPI

Tia Marie Krupp, D.P.T.

  • Physical Therapist
  • Fort Campbell, KY
National Provider Identifier
1730489279
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8813 Issued in TN
Practice address
650 Joel Dr
Fort Campbell, KY 42223
Phone
(270) 412-5170
NPI assigned
Nov 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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 8813 TN Primary

Addresses

Primary practice location

650 Joel Dr
Fort Campbell, KY 42223

Mailing address

1040 Chagford Dr
Clarksville, TN 37043-1626
Phone (812) 598-0987

Other names 1

  • Miss Tia Marie Williams Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1288569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1730489279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 CHAGFORD DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370431626",
            "telephone_number": "812-598-0987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "42223",
            "telephone_number": "270-412-5170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUPP",
        "first_name": "TIA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-01",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "8813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIA",
            "last_name": "WILLIAMS",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "credential": "D.P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Campbell, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; 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.