Individual provider Active NPI

Jackie M Kramer, DPT

  • Physical Therapist
  • Cincinnati, OH
National Provider Identifier
1912271503
Registry record updated Feb 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-012780 Issued in OH
Practice address
463 Ohio Pike
Suite 203
Cincinnati, OH 45255-3721
Phone
(513) 247-4340
Fax
(513) 247-4360
NPI assigned
Feb 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2012

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 PT-012780 OH Primary

Addresses

Primary practice location

463 Ohio Pike
Suite 203
Cincinnati, OH 45255-3721

Mailing address

463 Ohio Pike
Suite 203
Cincinnati, OH 45255-3721
Phone (513) 247-4340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120522001028 OH Practitioner - Physical Therapist in Private Practice 1557524923 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-012780OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Core Revive Physical Therapy and Wellness (Is the Dba, Jackie Kickish LLC) Physical Therapist Current Accepting new patients
Outpatient at Home LLC Physical Therapist CurrentSince Jan 23, 2026 Accepting new patients
Ohio Luna Care Physical Therapy LLC Physical Therapist CurrentSince Nov 18, 2022 Accepting new patients
Columbus Physical Therapy, LLC Physical Therapist PastSince Jan 23, 2026 Accepting new patients

Locations

4200 Regent St
Ste 200
Columbus, OH 43219
Phone (877) 581-2210

965 High St
Worthington, OH 43085
Phone (614) 327-2362

Organizations & group practices 4

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": "1330473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330473600000",
    "number": "1912271503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "463 OHIO PIKE",
            "address_2": "SUITE 203",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452553721",
            "telephone_number": "513-247-4340",
            "fax_number": "513-247-4360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463 OHIO PIKE",
            "address_2": "SUITE 203",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452553721",
            "telephone_number": "513-247-4340",
            "fax_number": "513-247-4360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAMER",
        "first_name": "JACKIE",
        "middle_name": "M",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-29",
        "last_updated": "2012-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT-012780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.