Organization Active NPI

Kendall L. Krug, OD PA

  • Optometrist
  • Hays, KS
National Provider Identifier
1104811025
Registry record updated Nov 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
KENDALL L. KRUG, OD PA
Practice address
2203 Canterbury Dr
Hays, KS 67601-2341
Phone
(785) 625-3937
Fax
(785) 625-7490
NPI assigned
Sep 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2008

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

Authorized official

Name
Dr. Kendall L Krug, O.D.
Title
Owner/Optometrist
Phone
(785) 625-3937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

2203 Canterbury Dr
Hays, KS 67601-2341

Mailing address

2203 Canterbury Dr
Hays, KS 67601-2341
Phone (785) 625-3937

Other identifiers 2

IdentifierTypeStateIssuer
650558OtherKSBLUECROSSBLUESHIELD
DC3867OtherRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

2203 Canterbury Dr
Hays, KS 67601
Phone (785) 625-3937

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226275200000",
    "number": "1104811025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2203 CANTERBURY DR",
            "city": "HAYS",
            "state": "KS",
            "postal_code": "676012341",
            "telephone_number": "785-625-3937",
            "fax_number": "785-625-7490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2203 CANTERBURY DR",
            "city": "HAYS",
            "state": "KS",
            "postal_code": "676012341",
            "telephone_number": "785-625-3937",
            "fax_number": "785-625-7490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENDALL L. KRUG, OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-16",
        "last_updated": "2008-11-10",
        "status": "A",
        "authorized_official_last_name": "KRUG",
        "authorized_official_first_name": "KENDALL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "785-625-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "650558",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC3867",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hays, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2008; 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.