Active NPI
Colleen McCracken, DPT
- Physical Therapist
- Fort Wayne, IN
National Provider Identifier
1821411331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05010922A
- Practice address
- 3898 New Vision Dr
BLDG 13, Suite D
Fort Wayne, IN 46845-1718 - Phone
- (260) 483-1010
- NPI assigned
- Feb 4, 2014
- 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 | 05010922A | IN | Primary |
Addresses
Primary practice location
3898 New Vision Dr
BLDG 13, Suite D
Fort Wayne, IN 46845-1718
Mailing address
1912 Stoners Mill Dr
Huntertown, IN 46748-9313
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": "1391472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391472000000",
"number": "1821411331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1912 STONERS MILL DR",
"city": "HUNTERTOWN",
"state": "IN",
"postal_code": "467489313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3898 NEW VISION DR",
"address_2": "BLDG 13, SUITE D",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451718",
"telephone_number": "260-483-1010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCRACKEN",
"first_name": "COLLEEN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-04",
"last_updated": "2014-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05010922A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.