Active NPI
Rudolf Kreps, LPT
- Physical Therapist
- Sandpoint, ID
National Provider Identifier
1871503771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT674
- Practice address
- 1301 N Division Ave
Sandpoint, ID 83864-8268 - Phone
- (208) 263-8866
- Fax
- (208) 265-8808
- NPI assigned
- Aug 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | PT674 | ID | Primary |
Addresses
Primary practice location
1301 N Division Ave
Sandpoint, ID 83864-8268
Mailing address
1301 N Division Ave
Sandpoint, ID 83864-8268
Phone (208) 263-8866
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| T6848 | Other | ID | BLUE CROSS ID |
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 |
|---|---|---|---|
| PT674 | ID | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871503771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 N DIVISION AVE",
"city": "SANDPOINT",
"state": "ID",
"postal_code": "838648268",
"telephone_number": "208-263-8866",
"fax_number": "208-265-8808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 N DIVISION AVE",
"city": "SANDPOINT",
"state": "ID",
"postal_code": "838648268",
"telephone_number": "208-263-8866",
"fax_number": "208-265-8808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KREPS",
"first_name": "RUDOLF",
"name_prefix": "Mr.",
"credential": "LPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "PT674",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS ID",
"identifier": "T6848",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sandpoint, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.