Healthcare Provider Details

I. General information

NPI: 1598454969
Provider Name (Legal Business Name): SCOTT KRAMER PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2023
Last Update Date: 06/07/2023
Certification Date: 06/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3215 MAIN ST
KANSAS CITY MO
64111-2645
US

IV. Provider business mailing address

4500 W 72ND ST
PRAIRIE VILLAGE KS
66208-2818
US

V. Phone/Fax

Practice location:
  • Phone: 816-472-1800
  • Fax:
Mailing address:
  • Phone: 913-220-7941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11-04524
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2023017876
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: