Kelly M Croghan, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3348 Issued in KY

Practice address

106 Diecks Dr
Elizabethtown, KY 42701-2443

Phone

(270) 769-0058

Fax

(270) 737-1659

NPI assigned

Mar 26, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Lumina of Campbellsville

  • Occupational Therapist
  • Campbellsville, KY
  • NPI 1972536084

  Physical Therapist

  NPD (past)
• Presbyterian Homes and Services of Kentucky, Inc.

  • Rehabilitation Clinic/Center
  • Elizabethtown, KY
  • NPI 1902839020

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363910400000",
    "number": "1992822571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 DIECKS DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012443",
            "telephone_number": "270-769-0058",
            "fax_number": "270-737-1659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 DIECKS DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012443",
            "telephone_number": "270-769-0058",
            "fax_number": "270-737-1659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROGHAN",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2013-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "3348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachariah Creekmore, TCADC
• Carolyn Crepps
• Josey H Crew, RD LD
• Susan L Crider
• Amber Crockett, PHARM D.
• Lance T Croghan, PT, ATC
• Richard Clint Cron, APRN
• Rebecca Cross
• Gwendolynn Faith Crouch
• Zachary David Culp, PSS

• Physical Therapist in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; 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.