Individual provider Active NPI

Cathy A Kruse

  • Physical Therapist
  • Woodstock, IL
National Provider Identifier
1790004729
Registry record updated Jun 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070010613 Issued in IL
Practice address
14231 Castlebar TRL
Woodstock, IL 60098-8881
Phone
(815) 338-5759
NPI assigned
Jun 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2010

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 070010613 IL Primary

Addresses

Primary practice location

14231 Castlebar TRL
Woodstock, IL 60098-8881

Mailing address

14231 Castlebar TRL
Woodstock, IL 60098-8881
Phone (815) 338-5759

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

LicenseStateTypeSpecialty
070010613ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1275350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275350400000",
    "number": "1790004729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14231 CASTLEBAR TRL",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600988881",
            "telephone_number": "815-338-5759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14231 CASTLEBAR TRL",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600988881",
            "telephone_number": "815-338-5759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "CATHY",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-01",
        "last_updated": "2010-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070010613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2010; 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.