KENNEDY JO KROECKEL – Physical Therapist, NPI 1366133894

KENNEDY JO KROECKEL is a healthcare provider. based in Defiance, Ohio. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. 020493 (OH). The NPI Number for KENNEDY JO KROECKEL is 1366133894

Main info

Female
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
KENNEDY JO KROECKEL
NPI
1366133894
Phone
(419) 785-4415
Address
851 S CLINTON ST
Enumeration Date
16 May 2023
Last Update Date
16 May 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4197854415
Graduation Year
2023 (3 years ago)
PAC ID
7315309556
Group Practice PAC ID
2466696380
Professional Enrollment ID
I20230818003347
Address ID
OH435122770DE851XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

2,243 PHYSICAL THERAPIST IN PRIVATE PRACTICE in OH

Provider Addresses for KENNEDY JO KROECKEL

  • 851 S CLINTON ST

    DEFIANCE, OH 435122770

    Phone: (419) 785-4415

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-08-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230818003347IPhysical Therapist In Private PracticeOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 43512)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2466696380View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeOH
-OH
Physical Therapist In Private PracticeOH
Physical Therapist In Private PracticeOH
Physical Therapist In Private PracticeOH
Physical Therapist In Private PracticeOH
Physical Therapist In Private PracticeOH
Physical Therapist In Private PracticeOH
Physical Therapist In Private PracticeOH

Reviews

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Frequently asked questions

How do payers reference KENNEDY JO KROECKEL?
For KENNEDY JO KROECKEL, use NPI 1366133894 as the unique 10-digit identifier.
Would KENNEDY JO KROECKEL appear as active to a payer?
You can treat KENNEDY JO KROECKEL as active for directory purposes; confirm clinical privileges separately.
What clinical focus is listed for KENNEDY JO KROECKEL?
At a glance, KENNEDY JO KROECKEL is tied to Physical Therapist. Clinical services aligned with this taxonomy classification.
Is KENNEDY JO KROECKEL located near Defiance?
KENNEDY JO KROECKEL currently maps to Defiance, Ohio in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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