Organization Active NPI

Kruger Clinic Orthopaedics, PLLC

  • Specialist
  • Edmonds, WA
National Provider Identifier
1215091368
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
601850391 Issued in WA
Legal business name
KRUGER CLINIC ORTHOPAEDICS, PLLC
Practice address
21600 Hwy 99 Ste 150
Edmonds, WA 98026
Phone
(425) 774-2636
Fax
(425) 774-2636
NPI assigned
Dec 21, 2006
Last updated
Dec 12, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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

Authorized official

Name
Thomas J Degan, M.D
Title
Medical Doctor
Phone
(425) 774-2636

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU
Specialist 174400000X 601850391 WA Primary

Addresses

Primary practice location

21600 Hwy 99 Ste 150
Edmonds, WA 98026

Mailing address

21600 Hwy 99 Ste 150
Edmonds, WA 98026
Phone (425) 774-2636

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323648000000",
    "number": "1215091368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21600 HWY 99 STE 150",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "98026",
            "telephone_number": "425-774-2636",
            "fax_number": "425-774-2688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21600 HWY 99 STE 150",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "98026",
            "telephone_number": "425-774-2636",
            "fax_number": "425-774-2636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRUGER CLINIC ORTHOPAEDICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2011-12-12",
        "status": "A",
        "authorized_official_last_name": "DEGAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "425-774-2636",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "601850391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; 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.