Katherine Kruse, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101231574 Issued in VA

Practice address

4211 Fairfax Corner East Ave
Suite 225
Fairfax, VA 22030-8622

Phone

(703) 502-4500

Fax

(703) 502-4518

NPI assigned

Apr 4, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Loudoun Community Health Center

  dba HealthWorks for Northern Virginia

  • Federally Qualified Health Center (FQHC)
  • Leesburg, VA
  • NPI 1629109806
  Medicare reassignment NPD
• Loudoun Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Sterling, VA
  • NPI 1144736901
  NPD

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

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207267200000",
    "number": "1285807719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 FAIRFAX CORNER EAST AVE",
            "address_2": "SUITE 225",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220308622",
            "telephone_number": "703-502-4500",
            "fax_number": "703-502-4518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 FAIRFAX CORNER EAST AVE",
            "address_2": "SUITE 225",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220308622",
            "telephone_number": "703-502-4500",
            "fax_number": "703-502-4518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "KATHERINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-04",
        "last_updated": "2008-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101231574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerri-Lynn Kriz, PH.D.
• Carolyn Rae Krol, LCSW
• Michael R Kronen, MD
• Courtney Krsmanovic, LCSW
• Amy Susan Krull, MA, CCC-SLP
• Allison J Krusinski
• Kenneth Kuberski, ATC
• Andrea Marie Kubota, FNP-BC
• Carolyn Elizabeth Kuchel, LPC, CSAC
• Karah Kuczarski, EDS

• Pediatrics Physician in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.