Active NPI
Shawn David Krueger, DPT
- Physical Therapist
- Alexandria, MN
National Provider Identifier
1497270714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 111 17TH Ave E Ste 101
Alexandria, MN 56308-3734 - Phone
- (320) 335-6067
- NPI assigned
- Aug 8, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
111 17TH Ave E Ste 101
Alexandria, MN 56308-3734
Mailing address
111 17TH Ave E
Alexandria, MN 56308-5273
Phone (320) 762-1511
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705536000000",
"number": "1497270714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 17TH AVE E",
"city": "ALEXANDRIA",
"state": "MN",
"postal_code": "563085273",
"telephone_number": "320-762-1511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 17TH AVE E STE 101",
"city": "ALEXANDRIA",
"state": "MN",
"postal_code": "563083734",
"telephone_number": "320-335-6067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUEGER",
"first_name": "SHAWN",
"middle_name": "DAVID",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-08",
"last_updated": "2024-01-18",
"certification_date": "2024-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Alexandria, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.