Kelsey Donnette Kruckeberg, APRN-CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R0114800 Issued in OK

Practice address

8115 S Memorial Dr
Tulsa, OK 74133-4331

Phone

(918) 254-6315

NPI assigned

Jul 23, 2019

Last updated

Jul 23, 2019By the provider in NPPES

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 OK

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Omni Medical Group Inc

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1174578249
  Medicare reassignment NPD

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1356994974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11528 S MULBERRY LN",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740372123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8115 S MEMORIAL DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334331",
            "telephone_number": "918-254-6315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUCKEBERG",
        "first_name": "KELSEY",
        "middle_name": "DONNETTE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-23",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0114800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sreelatha Kasuganti Krishna, M.D.
• Sonia Marie Krochak
• Kelsey Marie Krohner
• Hannah Mae Kropp
• Jay L Krottinger
• Krueger Family Chiropractic Clinic P.C.
• John P Krueger, D.C
• Mary Christine Krumm, LCSW
• Steve Krumm, IHS
• Diana M Krupenya

• Family Nurse Practitioner in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; 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.