Bryan Krueger, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

6072 Rosebud Rd
Metropolis, IL 62960-4119

Phone

(618) 524-1038

NPI assigned

Jan 4, 2007

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083761001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6072 ROSEBUD RD",
            "city": "METROPOLIS",
            "state": "IL",
            "postal_code": "629604119",
            "telephone_number": "618-524-1038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6072 ROSEBUD RD",
            "city": "METROPOLIS",
            "state": "IL",
            "postal_code": "629604119",
            "telephone_number": "618-524-1038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "BRYAN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "PT-003999",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russell Jones, DVM
• Christy Kennedy, APRN, FNP-C
• Michelle L Kent
• Kincaid King Physician Services, P.C.
• Amy Krueger, BS
• Krypton
• Kyle W Heine DMD PC
• Jeffrey Lange, D.C.
• John Larrison, APN, FNP-C
• Eileen Patrice Laurence, M.D.

• Physical Therapist in Metropolis, IL
• Providers in Metropolis, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.