Individual provider Active NPI

Samuel B Kriegler, M.D.

  • Urology Physician
  • Lebanon, KY
National Provider Identifier
1003929217
Registry record updated Jun 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
46375 Issued in KY
Practice address
420 Loretto Rd
Lebanon, KY 40033-1628
Phone
(270) 692-5139
Fax
(270) 699-4628
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 46375 KY Primary

Addresses

Primary practice location

420 Loretto Rd
Lebanon, KY 40033-1628

Mailing address

420 Loretto Rd
Lebanon, KY 40033-1628
Phone (270) 692-5139

Other identifiers 2

IdentifierTypeStateIssuer
163D2KROtherMNBCBS
324504700MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125136NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Woodland Urology, PA Urology CurrentSince Oct 25, 2004 Accepting new patients

Locations

3920 13th Ave E
Ste 6
Hibbing, MN 55746
Phone (218) 263-7540

901 9th St N
Ste 315
Virginia, MN 55792
Phone (218) 741-3340

Organizations & group practices 1

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372291200000",
    "number": "1003929217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 LORETTO RD",
            "city": "LEBANON",
            "state": "KY",
            "postal_code": "400331628",
            "telephone_number": "270-692-5139",
            "fax_number": "270-699-4628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 LORETTO RD",
            "city": "LEBANON",
            "state": "KY",
            "postal_code": "400331628",
            "telephone_number": "270-692-5139",
            "fax_number": "270-699-4628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIEGLER",
        "first_name": "SAMUEL",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2013-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "KY",
            "license": "46375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "163D2KR",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "324504700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.