Individual provider Active NPI

Christine Krueger, RN.RD,CDE,CDN

  • Diabetes Educator Registered Nurse
  • Auburn, NY
National Provider Identifier
1508931015
Registry record updated Mar 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetes Educator Registered NurseTaxonomy code 163WD0400X
License
2002-0328 Issued in NY
Practice address
37 W Garden St Ste 201
Auburn, NY 13021-2657
Phone
(315) 567-0700
Fax
(315) 253-8104
NPI assigned
Nov 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 003891-01 NY
Registered Nurse 163W00000X 613229-01 NY
Diabetes Educator Registered Nurse 163WD0400X 2002-0328 NY Primary

Addresses

Primary practice location

37 W Garden St Ste 201
Auburn, NY 13021-2657

Mailing address

37 W Garden St Ste 201
Auburn, NY 13021-2657
Phone (315) 567-0700

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
003891-01NYMDRegistered Dietitian
613229-01NYMDRegistered Nurse
2002-0328NYMDDiabetes Educator Registered Nurse
003891NYMDAcupuncturist
2911MAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1508931015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 W GARDEN ST STE 201",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130212657",
            "telephone_number": "315-567-0700",
            "fax_number": "315-253-8104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 W GARDEN ST STE 201",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130212657",
            "telephone_number": "315-567-0700",
            "fax_number": "315-253-8104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "CHRISTINE",
        "credential": "RN.RD,CDE,CDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "003891-01",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "613229-01",
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "NY",
            "license": "2002-0328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.