Individual provider Active NPI

Jeanne Alexandra Krick, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Jbsa Fort Sam Houston, TX
National Provider Identifier
1255605374
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
60563170 Issued in WA
Practice address
Brooke Army Medical Center
3551 Roger Brooke Drive
Jbsa Fort Sam Houston, TX 78234-4504
Phone
(253) 968-0895
NPI assigned
Mar 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 60563170 WA Primary

Addresses

Primary practice location

Brooke Army Medical Center
3551 Roger Brooke Drive
Jbsa Fort Sam Houston, TX 78234-4504

Mailing address

Brooke Army Medical Center
3551 Roger Brooke Drive
Jbsa Fort Sam Houston, TX 78234-4504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190322000786 WA Practitioner - Pediatric Medicine 3577877299 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Children'S Hospital CurrentSince Mar 4, 2019 Accepting new patients
Seattle Childrens Hospital CurrentSince Mar 4, 2019 Accepting new patients
Seattle Children'S Hospital Current Accepting new patients

Locations

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

8232 W Grandridge Blvd
Kennewick, WA 99336
Phone (509) 582-1700

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

1780 NW Myhre Rd
Ste 2120
Silverdale, WA 98383
Phone (360) 782-3100

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1255605374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BROOKE ARMY MEDICAL CENTER",
            "address_2": "3551 ROGER BROOKE DRIVE",
            "city": "JBSA FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BROOKE ARMY MEDICAL CENTER",
            "address_2": "3551 ROGER BROOKE DRIVE",
            "city": "JBSA FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "253-968-0895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRICK",
        "first_name": "JEANNE",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-07",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "WA",
            "license": "60563170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa Fort Sam Houston, TX

Sources for this page

Verify at the official NPI Registry.