Individual provider Active NPI

Jenifer R Kruse, MS, RDN, CDCES, CPT

  • Registered Dietitian
  • Aurora, CO
National Provider Identifier
1124212568
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
1635 Aurora CT
Aurora, CO 80045-2541
Phone
(720) 848-0000
NPI assigned
Aug 29, 2007
Last updated
Aug 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X CO Primary

Addresses

Primary practice location

1635 Aurora CT
Aurora, CO 80045-2541

Mailing address

322 Beard Creek Rd
Ste 1300
Edwards, CO 81632-6433
Phone (765) 838-8044

Other practice location 1

322 Beard Creek Road
Suite 1300
Edwards, CO 81632
Phone (970) 926-6340

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200819000059 CO Practitioner - Registered Dietitian Or Nutrition Professional 6103242391 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians Incorporated CurrentSince Apr 23, 2023 Accepting new patients
University Physicians Incorporated Current Accepting new patients

Locations

1635 Aurora Ct
Fl 3
Aurora, CO 80045
Phone (720) 848-1060

1635 Aurora Ct
Aurora, CO 80045
Phone (720) 848-1060

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

Dept 1061
Denver, CO 80256

322 Beard Creek Rd
Ste 1300
Edwards, CO 81632
Phone (970) 479-7251

1107 S Lemay Ave
Ste 410
Fort Collins, CO 80524
Phone (303) 315-6100

9397 Crown Crest Blvd
Ste 310
Parker, CO 80138
Phone (303) 699-3133

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": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1124212568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 BEARD CREEK RD",
            "address_2": "STE 1300",
            "city": "EDWARDS",
            "state": "CO",
            "postal_code": "816326433",
            "telephone_number": "765-838-8044",
            "fax_number": "765-838-8136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 AURORA CT",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452541",
            "telephone_number": "720-848-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "322 Beard Creek Road",
            "address_2": "Suite 1300",
            "address_purpose": "LOCATION",
            "city": "Edwards",
            "state": "CO",
            "postal_code": "81632",
            "country_code": "US",
            "telephone_number": "970-926-6340",
            "fax_number": "979-926-6348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "JENIFER",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "MS, RDN, CDCES, CPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-29",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.