Active NPI
Jean Robert Kroeger III, PHARM.D.
- Pharmacist
- Rapid City, SD
National Provider Identifier
1215319132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 6269
- Practice address
- 1415 Eglin St
Rapid City, SD 57701-9504 - Phone
- (605) 341-8621
- Fax
- (605) 341-8631
- NPI assigned
- Jun 27, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 6269 | SD | Primary |
Addresses
Primary practice location
1415 Eglin St
Rapid City, SD 57701-9504
Mailing address
1415 Eglin St
Rapid City, SD 57701-9504
Phone (605) 341-8621
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6269 | SD | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605571200000",
"number": "1215319132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1415 EGLIN ST",
"city": "RAPID CITY",
"state": "SD",
"postal_code": "577019504",
"telephone_number": "605-341-8621",
"fax_number": "605-341-8631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1415 EGLIN ST",
"city": "RAPID CITY",
"state": "SD",
"postal_code": "577019504",
"telephone_number": "605-341-8621",
"fax_number": "605-341-8631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KROEGER",
"first_name": "JEAN",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-27",
"last_updated": "2020-11-17",
"certification_date": "2020-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SD",
"license": "6269",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rapid City, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.