Individual provider Active NPI

Andrew Burton Krueger, D.C.

  • Chiropractor
  • Baxter, MN
National Provider Identifier
1205234598
Registry record updated Dec 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5997 Issued in MN
Practice address
7656 Design Rd
Baxter, MN 56425-8675
Phone
(218) 454-9355
Fax
(218) 454-9356
NPI assigned
Dec 18, 2014
Last updated
Dec 18, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5997 MN Primary

Addresses

Primary practice location

7656 Design Rd
Baxter, MN 56425-8675

Mailing address

7656 Design Rd
Baxter, MN 56425-8675
Phone (218) 454-9355

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150113001782 MN Practitioner - Chiropractic 4880918218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5936 Lexington Ave N
Shoreview, MN 55126-5604
Phone (651) 784-3396

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5997MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Willow Creek Chiropractic, PA Chiropractor CurrentSince Mar 1, 2017 Accepting new patients
Regenerative Medical Management Past Accepting new patients

Locations

5936 Lexington Ave N
Shoreview, MN 55126
Phone (651) 784-3396

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": "1418860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418860800000",
    "number": "1205234598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7656 DESIGN RD",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258675",
            "telephone_number": "218-454-9355",
            "fax_number": "218-454-9356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7656 DESIGN RD",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258675",
            "telephone_number": "218-454-9355",
            "fax_number": "218-454-9356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "ANDREW",
        "middle_name": "BURTON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-18",
        "last_updated": "2014-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baxter, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; 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.