Individual provider Active NPI

Kathryn Ann Kruser, APRN

  • Family Nurse Practitioner
  • Guilford, CT
National Provider Identifier
1174692842
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
001481 Issued in CT
Practice address
152 Broad St
Guilford, CT 06437
Phone
(203) 453-5235
Fax
(203) 453-6204
NPI assigned
Nov 7, 2006
Last updated
Apr 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 001481 CT Primary

Addresses

Primary practice location

152 Broad St
Guilford, CT 06437

Mailing address

152 Broad St
Guilford, CT 06437
Phone (203) 453-5235

Other identifiers 1

IdentifierTypeStateIssuer
004252673MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
001481CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Guilford Pediatrics Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kathy.kruser.1@27673.direct.athenahealth.com

Organizations & group practices 1

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1174692842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 BROAD ST",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "06437",
            "telephone_number": "203-453-5235",
            "fax_number": "203-453-6204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 BROAD ST",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "06437",
            "telephone_number": "203-453-5235",
            "fax_number": "203-453-6204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSER",
        "first_name": "KATHRYN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "001481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004252673",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Guilford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.