Individual provider Active NPI

Jonathan D Krueger, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Milwaukee, WI
National Provider Identifier
1316571896
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
19912 Issued in WI
Practice address
3237 S 16TH St
Milwaukee, WI 53215-4526
Phone
(414) 647-5043
NPI assigned
Feb 24, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 19912 WI Primary

Addresses

Primary practice location

3237 S 16TH St
Milwaukee, WI 53215-4526

Mailing address

2208 N 61St St Uppr
Milwaukee, WI 53213-1502
Phone (262) 220-9472

Other practice location 1

N83W15701 Appleton Ave
Menomonee Falls, WI 53051-3042
Phone (262) 251-3890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
19912WIMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1316571896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2208 N 61ST ST UPPR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532131502",
            "telephone_number": "262-220-9472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3237 S 16TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154526",
            "telephone_number": "414-647-5043"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N83W15701 Appleton Ave",
            "address_purpose": "LOCATION",
            "city": "Menomonee Falls",
            "state": "WI",
            "postal_code": "530513042",
            "country_code": "US",
            "telephone_number": "262-251-3890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "JONATHAN",
        "middle_name": "D",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-24",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "WI",
            "license": "19912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.