Individual provider Active NPI

Kerri Jill Krueger, NP

  • Neonatal Nurse Practitioner
  • Camp Lejeune, NC
National Provider Identifier
1467606301
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
19877 Issued in SC
Practice address
100 Brewster Blvd
Naval Hospital
Camp Lejeune, NC 28547-2538
Phone
(910) 450-3677
Fax
(910) 450-3774
NPI assigned
Nov 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5002818 NC
Neonatal Nurse Practitioner 363LN0000X 19877 SC Primary

Addresses

Primary practice location

100 Brewster Blvd
Naval Hospital
Camp Lejeune, NC 28547-2538

Mailing address

100 Brewster Blvd
Naval Hospital
Camp Lejeune, NC 28547-2538
Phone (910) 450-3677

Other practice location 1

20 Medical Campus Dr NW Ste 205
Supply, NC 28462-4094
Phone (910) 721-4400

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20250529001674 NC Practitioner - Nurse Practitioner 4587951884 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
19877SCMDMOHS-Micrographic Surgery Physician
5002818NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Mar 20, 2025 Accepting new patients
Novant Health Medical Group LLC CurrentSince Mar 20, 2025 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

517 S Sharon Amity Rd
Charlotte, NC 28211
Phone (704) 384-1406

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

20 Medical Campus Dr NW
Ste 205
Supply, NC 28462
Phone (910) 721-4400

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1467606301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "address_2": "NAVAL HOSPITAL",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472538",
            "telephone_number": "910-450-3677",
            "fax_number": "910-450-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "address_2": "NAVAL HOSPITAL",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472538",
            "telephone_number": "910-450-3677",
            "fax_number": "910-450-3774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Medical Campus Dr NW Ste 205",
            "address_purpose": "LOCATION",
            "city": "Supply",
            "state": "NC",
            "postal_code": "284624094",
            "country_code": "US",
            "telephone_number": "910-721-4400",
            "fax_number": "910-721-4409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "KERRI",
        "middle_name": "JILL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-05",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5002818",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "SC",
            "license": "19877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Lejeune, NC

Sources for this page

Verify at the official NPI Registry.