Kimberly Kruse

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1158 Issued in SC

Practice address

11 Richland Medical Park Dr
Columbia, SC 29203-6863

Phone

(803) 434-4838

Fax

(803) 434-4852

NPI assigned

Dec 13, 2010

Sex

Female

Sole proprietor

Yes

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 SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkruse381329@direct.ghs.myhfn.org

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.

• Musc Community Physicians

  • Internal Medicine Physician
  • Bamberg, SC
  • NPI 1841878006
  Medicare reassignment NPD
• Prisma Health Medical Group-Midlands

  • Multi-Specialty Clinic/Center
  • Columbia, SC
  • NPI 1275988321
  Medicare reassignment NPD
• Musc Community Physicians

  • Rural Health Clinic/Center
  • Bowman, SC
  • NPI 1225735772
  NPD
• Prisma Health Medical Group-Midlands

  • Oral and Maxillofacial Surgery (Dentist)
  • Columbia, SC
  • NPI 1417442864
  NPD
• Prisma Health Medical Group-Midlands

  • Durable Medical Equipment & Medical Supplies
  • Columbia, SC
  • NPI 1881469856
  NPD

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

{
    "created_epoch": "1292198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314921600000",
    "number": "1366745416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 RICHLAND MEDICAL PARK DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036863",
            "telephone_number": "803-434-4838",
            "fax_number": "803-434-4852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 RICHLAND MEDICAL PARK DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036863",
            "telephone_number": "803-434-4838",
            "fax_number": "803-434-4852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-13",
        "last_updated": "2011-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "SC",
            "license": "1158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Krstacic, MD
• Kailey Kruis, MA, LPCA
• Matthew Krumholz
• Joseph John Krupa III, DDS
• Aylin D Kruse
• KTP Wellness Solution LLC
• Janet L Kubas, NP
• Karen Kubinec, N.P.
• Navya Kuchipudi, M.D.
• Jessica Lauren Kuchta, PT

• Clinical Psychologist in Columbia, SC
• Providers in Columbia, SC by specialty
• Clinical Psychologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; 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.