Individual provider Active NPI

Krista Rae Howard, DPT

  • Physical Therapist
  • Keizer, OR
National Provider Identifier
1851751184
Registry record updated Jun 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
61516 Issued in OR
Practice address
4025 Cherry Ave NE
Keizer, OR 97303-4859
Phone
(503) 390-9009
NPI assigned
Feb 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2017

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 61516 OR Primary

Addresses

Primary practice location

4025 Cherry Ave NE
Keizer, OR 97303-4859

Mailing address

PO Box 21563
Keizer, OR 97307-1563
Phone (503) 390-9009

Other names 1

  • Krista Rae Kelly 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

State licenses

LicenseStateTypeSpecialty
61415ORMDGeriatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Physical Therapy LLC. Current Accepting new patients

Locations

210 W Ellendale Ave
Ste 100
Dallas, OR 97338
Phone (503) 623-2433

4025 Cherry Ave NE
Keizer, OR 97303
Phone (503) 390-9009

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1456704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496880000000",
    "number": "1851751184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21563",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973071563",
            "telephone_number": "503-390-9009",
            "fax_number": "503-393-0834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 CHERRY AVE NE",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034859",
            "telephone_number": "503-390-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWARD",
        "first_name": "KRISTA",
        "middle_name": "RAE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-29",
        "last_updated": "2017-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "61516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTA",
            "last_name": "KELLY",
            "middle_name": "RAE",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Keizer, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2017; 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.