Individual provider Active NPI

Katelin C Krueger, DC

  • Chiropractor
  • River Falls, WI
National Provider Identifier
1114771680
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
615412 Issued in WI
Practice address
1660 Wisconsin St
River Falls, WI 54022-3207
Phone
(715) 220-0394
NPI assigned
Apr 12, 2024
Last updated
Apr 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 615412 WI Primary

Addresses

Primary practice location

1660 Wisconsin St
River Falls, WI 54022-3207

Mailing address

1660 Wisconsin St
River Falls, WI 54022-3207
Phone (715) 220-0394

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240704000564 WI Practitioner - Chiropractic 0941744676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rae Chiropractic, LLCGroup PAC ID 2062637267, 4 clinicians

Practice addresses (Care Compare)

1380 N Acres Rd
Suite a
Prescott, WI 54021-7024
Phone (715) 262-8555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
615412WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Rae Chiropractic, LLC Chiropractor CurrentSince Jun 3, 2024 Accepting new patients
Nevin Chiropractic SC Chiropractor PastSince Jun 3, 2024 Accepting new patients

Locations

1380 N Acres Rd
Ste A
Prescott, WI 54021
Phone (715) 262-8555

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1712880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1114771680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 WISCONSIN ST",
            "city": "RIVER FALLS",
            "state": "WI",
            "postal_code": "540223207",
            "telephone_number": "715-220-0394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 WISCONSIN ST",
            "city": "RIVER FALLS",
            "state": "WI",
            "postal_code": "540223207",
            "telephone_number": "715-220-0394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "KATELIN",
        "middle_name": "C",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-12",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "615412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in River Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.