Individual provider Active NPI

Kelly Ann Krueger, APRN

  • Family Nurse Practitioner
  • Eustis, FL
National Provider Identifier
1245768969
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9173988 Issued in FL
Practice address
2906 David Walker Dr
Eustis, FL 32726-6177
Phone
(352) 363-5921
Fax
(352) 589-5771
NPI assigned
May 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

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 APRN9173988 FL Primary

Addresses

Primary practice location

2906 David Walker Dr
Eustis, FL 32726-6177

Mailing address

2906 David Walker Dr
Eustis, FL 32726-6177
Phone (352) 363-5921

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20171011002915 FL Practitioner - Nurse Practitioner 6901171313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adventhealth Senior Care IncGroup PAC ID 7618397886, 32 clinicians

Practice addresses (Care Compare)

2906 David Walker Dr
Eustis, FL 32726-6177
Phone (352) 363-5921

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN9173988FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adventhealth Senior Care Inc CurrentSince Apr 21, 2025 Accepting new patients

Locations

2906 David Walker Dr
Eustis, FL 32726
Phone (352) 363-5921

290 Clyde Morris Blvd
Ormond Beach, FL 32174
Phone (386) 615-6642

Interoperability endpoints

  • Direct secure messaging: kelly.krueger.1@29290.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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1245768969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2906 DAVID WALKER DR",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327266177",
            "telephone_number": "352-363-5921",
            "fax_number": "352-589-5771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2906 DAVID WALKER DR",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327266177",
            "telephone_number": "352-363-5921",
            "fax_number": "352-589-5771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-25",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9173988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eustis, FL

Sources for this page

Verify at the official NPI Registry.