Jon Russell Krueger, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704205426 Issued in MI

Practice address

420 W 5TH Ave
Flint, MI 48503-2445

Phone

(810) 257-3736

Fax

(989) 723-1205

NPI assigned

Jun 27, 2012

Last updated

Jul 21, 2022By the provider in NPPES

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of Cincinnati College of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Genesee Health SystemGroup PAC ID 6002051091, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Genesee Health System

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Flint, MI
  • NPI 1043554348
  Medicare reassignment Care Compare group NPD
• Mid-Michigan Behavioral Health, PC

  • Psychiatry Physician
  • Owosso, MI
  • NPI 1083823835

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Genesee Health System

  dba Genesee Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Flint, MI
  • NPI 1962140137

  Nurse Practitioner

  NPD
• Consumer Services, Inc.

  dba Taylor Life Center

  • Adult Mental Health Clinic/Center
  • Mason, MI
  • NPI 1306876735
  NPD (past)
• Consumer Services, Inc.

  dba Taylor Life Center

  • Clinical Social Worker
  • Mason, MI
  • NPI 1700066339
  NPD (past)
• Memorial Hospital

  dba Memorial Medical Associates

  • Anesthesiology Physician
  • Owosso, MI
  • NPI 1659527737
  NPD (past)

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

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1033473749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W 5TH AVE",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032445",
            "telephone_number": "810-257-3736",
            "fax_number": "989-723-1205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W 5TH AVE",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032445",
            "telephone_number": "810-257-3736",
            "fax_number": "989-723-1205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "721 N Shiawassee St",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Owosso",
            "state": "MI",
            "postal_code": "488671632",
            "country_code": "US",
            "telephone_number": "989-725-8124",
            "fax_number": "989-723-1205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "JON",
        "middle_name": "RUSSELL",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-27",
        "last_updated": "2022-07-21",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704205426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kroger Co of Michigan (Kroger Pharmacy)
• Kroger Co of Michigan (Kroger Pharmacy Dba Kessel)
• Kroger Co of Michigan (Kroger Pharmacy Dba Kessel)
• Lucinda Renee Kroll, DNP
• Emily Krueger, OD
• Robert R Krueger, RPH
• Trisha Louise Krul
• William C Krupp, RPH
• Brock Krygier, DDS
• Terry Scott Krznarich, MD

• Psychiatric/Mental Health Nurse Practitioner in Flint, MI
• Providers in Flint, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.