Individual provider Active NPI

Jill A Krug, ACNP

  • Acute Care Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1306170790
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
71003115A Issued in IN
Practice address
3700 Washington Ave
Evansville, IN 47714-0541
Phone
(812) 485-7040
Fax
(812) 485-7042
NPI assigned
Oct 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 71003115A IN Primary

Addresses

Primary practice location

3700 Washington Ave
Evansville, IN 47714-0541

Mailing address

3700 Washington Ave
Evansville, IN 47714-0541

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jill.krug.2@7598.direct.athenahealth.com St Mary's Medical Group, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20100319000511 IN Practitioner - Nurse Practitioner 0042345720 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71003115AINMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary'S Medical Group, LLC Acute Care CurrentSince Nov 5, 2015 Accepting new patients
Primary Physicians Network LLC Current Accepting new patients
St Mary'S Medical Group, LLC CurrentSince Nov 5, 2015 Accepting new patients

Locations

801 Saint Marys Dr
Ste 505E
Evansville, IN 47714
Phone (812) 491-3236

3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021

3801 Bellemeade Ave
Ste 110
Evansville, IN 47714
Phone (812) 471-1200

1400 Professional Blvd
Ste 210
Evansville, IN 47714

473 SE Greenville Ave
Winchester, IN 47394
Phone (765) 584-0004

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": "1254355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1306170790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 WASHINGTON AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 WASHINGTON AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140541",
            "telephone_number": "812-485-7040",
            "fax_number": "812-485-7042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUG",
        "first_name": "JILL",
        "middle_name": "A",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-01",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71003115A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jill.krug.2@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St Mary's Medical Group, LLC",
            "address_1": "3700 Washington Ave",
            "city": "Evansville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "477140541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.