Active NPI
Jeremy Sean Kruger, MSPT
- Physical Therapist
- Winchester, KY
National Provider Identifier
1326045360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 004175
- Practice address
- 404 Shoppers Dr
Winchester, KY 40391-1378 - Phone
- (859) 737-5333
- Fax
- (859) 737-0070
- NPI assigned
- Jul 6, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 004175 | KY | Primary |
Addresses
Primary practice location
404 Shoppers Dr
Winchester, KY 40391-1378
Mailing address
404 Shoppers Dr
Winchester, KY 40391-1378
Phone (859) 737-5333
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004175 | KY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gme Enterprises PSC | Physical Therapist | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Physical Therapist
- Lexington, KY
- NPI 1134572993
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393286400000",
"number": "1326045360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "404 SHOPPERS DR",
"city": "WINCHESTER",
"state": "KY",
"postal_code": "403911378",
"telephone_number": "859-737-5333",
"fax_number": "859-737-0070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 SHOPPERS DR",
"city": "WINCHESTER",
"state": "KY",
"postal_code": "403911378",
"telephone_number": "859-737-5333",
"fax_number": "859-737-0070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUGER",
"first_name": "JEREMY",
"middle_name": "SEAN",
"name_prefix": "Mr.",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-06",
"last_updated": "2014-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KY",
"license": "004175",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winchester, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.