Active NPI
Janet Krueger, M.D.
- Emergency Medical Services (Emergency Medicine) Physician
- College Station, TX
National Provider Identifier
1104874809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medical Services (Emergency Medicine) Physician
- License
- K1230
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 113489209 | Medicaid | TX |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 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.