Individual provider Active NPI

Luke Daniel Krautter, M.D.

  • Family Medicine Physician
  • Statesboro, GA
National Provider Identifier
1336434992
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
080854 Issued in GA
Practice address
1140 Brampton Ave
Statesboro, GA 30458
Phone
(912) 871-2273
Fax
(912) 871-2274
NPI assigned
Jun 12, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 080854 GA Primary

Addresses

Primary practice location

1140 Brampton Ave
Statesboro, GA 30458

Mailing address

1140 Brampton Ave
Statesboro, GA 30458
Phone (912) 871-2273

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20190326002062 GA Practitioner - Family Practice 5890017891 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Cincinnati College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern Family Medicine of Georgia, LLCGroup PAC ID 6608914056, 10 clinicians

Practice addresses (Care Compare)

1140 Brampton Ave
Statesboro, GA 30458-0847
Phone 9128712273128

Hospital & facility affiliations

  • East Georgia Regional Medical Center Hospital, Statesboro, GA, CCN 110075
  • Evans Memorial Hospital Hospital, Claxton, GA, CCN 110142

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
080854GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Urgent Care LLC CurrentSince Jul 17, 2023 Accepting new patients
Southern Family Medicine of Georgia, LLC Family Medicine CurrentSince Jan 14, 2019 Accepting new patients
Rural Urgent Care LLC Family Medicine CurrentSince Jul 17, 2023 Accepting new patients

Locations

1500 1st Ave N
Unit 3
Birmingham, AL 35203
Phone (205) 545-5088

1408 Tallahassee Hwy
Ste Z
Bainbridge, GA 39819
Phone (229) 400-9033

308 E Long St
Claxton, GA 30417
Phone (912) 290-5235

1044 Bermuda Run
Statesboro, GA 30458
Phone (912) 871-2273

1140 Brampton Ave
Statesboro, GA 30458
Phone (912) 871-2273

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1307836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1336434992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 BRAMPTON AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458",
            "telephone_number": "912-871-2273",
            "fax_number": "912-871-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 BRAMPTON AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458",
            "telephone_number": "912-871-2273",
            "fax_number": "912-871-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAUTTER",
        "first_name": "LUKE",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-12",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "080854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

Verify at the official NPI Registry.