Kurt Kroenke, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01047267A Issued in IN

Practice address

1002 Wishard Blvd
4TH FL
Indianapolis, IN 46202-2872

Phone

(317) 692-2323

Fax

(317) 656-3967

NPI assigned

May 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241654400000",
    "number": "1386602373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78158",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462780158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 WISHARD BLVD",
            "address_2": "4TH FL",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022872",
            "telephone_number": "317-692-2323",
            "fax_number": "317-656-3967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROENKE",
        "first_name": "KURT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2009-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01047267A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200157970",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret Krizon
• Mallory Krkoska, M.S
• Hannah Grace Krodel, LMHC, ATR-BC
• Ashley R Kroeger, MD
• Kathryn Ann Kroeger, M.D.
• Elizabeth A Kroepfl, MD
• Courtney Leanne Kroes, LCSW
• Michael D Kroft, D.C.
• Kroger Limited Partnership I
• Kroger Limited Partnership I

• Internal Medicine Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2009; 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.