Active NPI
Courtney Jane Kruscavage
- Athletic Trainer
- Lititz, PA
National Provider Identifier
1780106179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 30426887
- Practice address
- 51 Peters Rd
Lititz, PA 17543-7685 - Phone
- (717) 627-7575
- NPI assigned
- Jul 7, 2017
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 30426887 | PA | Primary |
Addresses
Primary practice location
51 Peters Rd
Lititz, PA 17543-7685
Mailing address
13 Stonehouse BND
Willow Street, PA 17584-7803
Phone (843) 780-1222
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30426887 | PA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706486400000",
"number": "1780106179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13 STONEHOUSE BND",
"city": "WILLOW STREET",
"state": "PA",
"postal_code": "175847803",
"telephone_number": "843-780-1222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 PETERS RD",
"city": "LITITZ",
"state": "PA",
"postal_code": "175437685",
"telephone_number": "717-627-7575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUSCAVAGE",
"first_name": "COURTNEY",
"middle_name": "JANE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-07",
"last_updated": "2024-01-29",
"certification_date": "2024-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "PA",
"license": "30426887",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lititz, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.