Individual provider Active NPI

Katherine Krueger

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1275086167
Registry record updated Jul 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
43031 Issued in CA
Practice address
8344 Clairemont Mesa Blvd
Ste. 110
San Diego, CA 92111-1307
Phone
(858) 565-6910
Fax
(858) 565-6911
NPI assigned
Jul 27, 2016
Last updated
Jul 27, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 43031 CA Primary

Addresses

Primary practice location

8344 Clairemont Mesa Blvd
Ste. 110
San Diego, CA 92111-1307

Mailing address

8344 Clairemont Mesa Blvd
Ste. 110
San Diego, CA 92111-1307

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161207002603 CA Practitioner - Physical Therapist in Private Practice 5597045633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Emory University School of Medicine, 2015
Medicare assignment
May accept Medicare assignment
Group practices
PT in MotionGroup PAC ID 7315997285, 7 clinicians

Practice addresses (Care Compare)

5473 Kearny Villa Rd
Suite 100
San Diego, CA 92123-1160
Phone (858) 565-6910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
43031CAMDPharmacotherapy Pharmacist

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, 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": "1469577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469577600000",
    "number": "1275086167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8344 CLAIREMONT MESA BLVD",
            "address_2": "STE. 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921111307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8344 CLAIREMONT MESA BLVD",
            "address_2": "STE. 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921111307",
            "telephone_number": "858-565-6910",
            "fax_number": "858-565-6911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "KATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-27",
        "last_updated": "2016-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "43031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2016; 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.