Jazz Dominic Kroeger, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

125.083662 Issued in IL

Practice address

751 N Rutledge St Ste 3100
Springfield, IL 62702-4968

Phone

(217) 814-5178

Fax

(217) 757-6458

NPI assigned

May 27, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

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": "1716768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1427898642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 N RUTLEDGE ST STE 3100",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627024968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 N RUTLEDGE ST STE 3100",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627024968",
            "telephone_number": "217-814-5178",
            "fax_number": "217-757-6458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROEGER",
        "first_name": "JAZZ",
        "middle_name": "DOMINIC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-27",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.083662",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "125.083662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa B. Kreiling, DNP
• Debra Krick, SLP
• Kasturi Kripakaran, M.D.
• Kristen Clow, Ma, Licensed Clinical Professional Counselor, PLLC
• Emily Krivi
• Courtney Rianne Krofchick
• Emily A Krofchick
• Courtney Brooke Krohe, N.P.
• Isabella Lynne Kronewitter, RBT
• Henry William Krug IV, D.C.

• Diagnostic Radiology Physician in Springfield, IL
• Providers in Springfield, IL by specialty
• Diagnostic Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.