Leann Kridelbaugh, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

J8629 Issued in TX

Practice address

2750 W. Northwest Hwy
Suite 170
Dallas, TX 75220-4783

Phone

(214) 654-0007

Fax

(214) 654-9272

NPI assigned

Sep 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Samuel U. Rodgers Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Kansas City, MO
  • NPI 1578570982
  Medicare reassignment NPD
• Samuel U. Rodgers Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Kansas City, MO
  • NPI 1326674144
  NPD
• Physicians for Children

  • Social Worker
  • Dallas, TX
  • NPI 1558771014
  NPD (past)

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312329600000",
    "number": "1174627699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7547 GREENBRIER DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752254514",
            "telephone_number": "214-692-5361",
            "fax_number": "214-456-6819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 W. NORTHWEST HWY",
            "address_2": "SUITE 170",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752204783",
            "telephone_number": "214-654-0007",
            "fax_number": "214-654-9272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIDELBAUGH",
        "first_name": "LEANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2011-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "J8629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139112019",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139112021",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TPI",
            "identifier": "176920001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139112017",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139112026",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139112020",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lesley Ann Kresie, M.D.
• Adam Blaine Kretzer, MD
• Magdalene Kreuz
• Laura Michelle Krey, PA
• Cole Lindsey Kricken, D.C.
• Keith A Kriegel, D.D.S.
• Matthew James Krieger, DMD
• Theodore Jefferson Krieger
• Anne Elizabeth Kriegshauser, APRN
• William John Krippner Jr., MD

• Pediatrics Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; 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.

Verify at the official NPI Registry.