Individual provider Active NPI

Jonathan Ryan Kretsch, DPT

  • Physical Therapist
  • Baltimore, MD
National Provider Identifier
1922511872
Registry record updated Nov 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
26776 Issued in MD
Practice address
7939 Honeygo Blvd Ste 131
Baltimore, MD 21236-5905
Phone
(410) 931-2738
Fax
(410) 931-2739
NPI assigned
Nov 14, 2017
Last updated
Nov 14, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 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 26776 MD Primary

Addresses

Primary practice location

7939 Honeygo Blvd Ste 131
Baltimore, MD 21236-5905

Mailing address

3455 Highway 81 South
Loganville, GA 30052-3918
Phone (770) 554-0665

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171226001061 MD Practitioner - Physical Therapist in Private Practice 4587922489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7850 Rossville Blvd
Suite 206 208
Baltimore, MD 21236-3934
Phone (410) 931-2738

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26776MDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy of Maryland LLC Physical Therapist CurrentSince Nov 30, 2017 Accepting new patients
Drayer Physical Therapy of Maryland LLC Physical Therapist CurrentSince Nov 30, 2017 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

998 Hospitality Way
Ste 101
Aberdeen, MD 21001
Phone (410) 273-9776

7850 Rossville Blvd
Ste 206208
Baltimore, MD 21236
Phone (410) 931-2738

7939 Honeygo Blvd
Ste 131
Nottingham, MD 21236
Phone (410) 931-2738

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510617600000",
    "number": "1922511872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3455 HIGHWAY 81 SOUTH",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300523918",
            "telephone_number": "770-554-0665",
            "fax_number": "770-554-0685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7939 HONEYGO BLVD STE 131",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212365905",
            "telephone_number": "410-931-2738",
            "fax_number": "410-931-2739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRETSCH",
        "first_name": "JONATHAN",
        "middle_name": "RYAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-14",
        "last_updated": "2017-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "26776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.