Jon Kroenke, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

30105 Issued in NE

Practice address

3775 45TH Avenue
Columbus, NE 68601

Phone

(402) 564-7200

Fax

(402) 564-7210

NPI assigned

Jun 18, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• CCH Pediatric Clinic PC

  • Pediatrics Physician
  • Columbus, NE
  • NPI 1033126107
  NPD (past)
• CCH Pediatric Clinic PC

  • Pediatrics Physician
  • Columbus, NE
  • NPI 1033763859
  NPD (past)
• Columbus Community Hospital Inc

  • General Acute Care Hospital
  • Columbus, NE
  • NPI 1760589295
  NPD (past)

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

{
    "created_epoch": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517184000000",
    "number": "1083028013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 1066",
            "city": "COLUMBUS",
            "state": "NE",
            "postal_code": "68602",
            "telephone_number": "402-564-7200",
            "fax_number": "402-564-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3775 45TH AVENUE",
            "city": "COLUMBUS",
            "state": "NE",
            "postal_code": "68601",
            "telephone_number": "402-564-7200",
            "fax_number": "402-564-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROENKE",
        "first_name": "JON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-18",
        "last_updated": "2018-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "7239",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "30105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Kay Kracl
• Jacob Zachary Kratochvil
• Charlene Kay Kresha
• Brooke Krings, PA-C
• Kerry Jo Krings, O.D.
• Eve Kronberg
• Kaylee Marie Krotter-Hoadley, CRNA
• Anthony C Krueger, M.D.
• Brooke Morgan Kruse
• Faith Ann Ann Kruse

• Pediatrics Physician in Columbus, NE
• Providers in Columbus, NE by specialty
• Pediatrics Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.