Individual provider Active NPI

Tammy Kruger, CNP

  • Adult Health Nurse Practitioner
  • Novi, MI
National Provider Identifier
1184135766
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN.CNP.023708 Issued in OH
Practice address
41800 W 11 Mile Rd Ste 109
Novi, MI 48375-1818
Phone
(248) 660-1220
NPI assigned
Oct 23, 2017
Last updated
May 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN.CNP.023708 OH Primary

Addresses

Primary practice location

41800 W 11 Mile Rd Ste 109
Novi, MI 48375-1818

Mailing address

118 E Indiana Ave
Maumee, OH 43537-2826
Phone (419) 794-3006

Other practice location 1

118 E Indiana Ave
Maumee, OH 43537-2826
Phone (419) 794-3006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181206003414 OH Practitioner - Nurse Practitioner 0941544654 Reassigns benefits to 3 organizations
I20200803001170 MI Practitioner - Nurse Practitioner 0941544654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peyton Care Professionals LLCGroup PAC ID 8022260413, 6 clinicians
Onyx Sands Senior Care PCGroup PAC ID 1951815315, 6 clinicians

Practice addresses (Care Compare)

118 E Indiana Ave
Maumee, OH 43537-2826
Phone (419) 893-9230

121 Fairway Ave
Piketon, OH 45661-9123
Phone (740) 352-7733

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peyton Care Professionals, LLC CurrentSince Nov 1, 2018 Accepting new patients
Cardinal Virtues Long Term Care CurrentSince Dec 26, 2025 Accepting new patients
Theoria Medical Nurse Practitioner CurrentSince Jul 9, 2024 Accepting new patients

Locations

730 Kimole Ln
Ste B
Adrian, MI 49221

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

111 Clinton St
Maumee, OH 43537
Phone (419) 740-3022

118 E Indiana Ave
Maumee, OH 43537
Phone (419) 794-3026

717 S 30th St
Newark, OH 43056
Phone (740) 522-1171

1030 High St
Worthington, OH 43085
Phone (614) 876-7356

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1184135766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 E INDIANA AVE",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435372826",
            "telephone_number": "419-794-3006",
            "fax_number": "419-794-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41800 W 11 MILE RD STE 109",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751818",
            "telephone_number": "248-660-1220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "118 E Indiana Ave",
            "address_purpose": "LOCATION",
            "city": "Maumee",
            "state": "OH",
            "postal_code": "435372826",
            "country_code": "US",
            "telephone_number": "419-794-3006",
            "fax_number": "419-794-3006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRUGER",
        "first_name": "TAMMY",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-23",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "APRN.CNP.023708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.