Individual provider Active NPI

Janet Krueger, M.D.

  • Emergency Medical Services (Emergency Medicine) Physician
  • College Station, TX
National Provider Identifier
1104874809
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
K1230 Issued in TX
Practice address
4421 Highway 6 S Ste 100
College Station, TX 77845-6176
Phone
(979) 731-5200
Fax
(979) 731-5210
NPI assigned
May 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K1230 TX
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X K1230 TX Primary

Addresses

Primary practice location

4421 Highway 6 S Ste 100
College Station, TX 77845-6176

Mailing address

2800 S Texas Ave
Ste 202
Bryan, TX 77802-5361
Phone (979) 774-2053

Other practice location 1

2801 Franciscan Dr
Bryan, TX 77802-2544
Phone (979) 776-2568

Other identifiers 1

IdentifierTypeStateIssuer
113489209MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20040616000944 TX Practitioner - Family Practice 8921082967

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1104874809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 S TEXAS AVE",
            "address_2": "STE 202",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778025361",
            "telephone_number": "979-774-2053",
            "fax_number": "979-776-5914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4421 HIGHWAY 6 S STE 100",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778456176",
            "telephone_number": "979-731-5200",
            "fax_number": "979-731-5210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 Franciscan Dr",
            "address_purpose": "LOCATION",
            "city": "Bryan",
            "state": "TX",
            "postal_code": "778022544",
            "country_code": "US",
            "telephone_number": "979-776-2568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "JANET",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K1230",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TX",
            "license": "K1230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113489209",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

Verify at the official NPI Registry.