Chantal Cousineau-Krieger, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

01061283A Issued in IN

Practice address

59TH Medical Winge Ge
2200 Bergquist Drive Ste 1
Lackland AFB, TX 78236-9908

Phone

(240) 505-2613

NPI assigned

Sep 22, 2005

Last updated

Aug 14, 2015By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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.

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": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439510400000",
    "number": "1487640785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050W PERIMETER RD",
            "city": "JB ANDREWS",
            "state": "MD",
            "postal_code": "207626601",
            "telephone_number": "240-587-4928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59TH MEDICAL WINGE GE",
            "address_2": "2200 BERGQUIST DRIVE STE 1",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "782369908",
            "telephone_number": "240-505-2613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUSINEAU-KRIEGER",
        "first_name": "CHANTAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-22",
        "last_updated": "2015-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "101061283A",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "01061283A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corey Dequan Cooper, PHARM.D.
• Jared Brian Cooper
• Paula Corrigan
• Laura Cosimi, MD
• Don Coughlin
• William John Craig
• Tanya Crail, R.D.
• Marcus Milo Cranston, MD
• Rose Mary Crayne, MS OTR
• Kellie Courtney Crowe, PH.D.

• Ophthalmology Physician in Lackland AFB, TX
• Providers in Lackland AFB, TX by specialty
• Ophthalmology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2015; 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.