Active NPI
Daniel Norman Kreager, DDS
- Dentist
- Elkhart, IN
National Provider Identifier
1508959545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12009077A
- Practice address
- 236 Simpson Ave
Elkhart, IN 46516 - Phone
- (574) 293-0052
- Fax
- (574) 293-3744
- NPI assigned
- Oct 2, 2006
- Last updated
- Jan 15, 2019
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 12009077A | IN | Primary |
Addresses
Primary practice location
236 Simpson Ave
Elkhart, IN 46516
Mailing address
236 Simpson Ave
Elkhart, IN 46516-4666
Phone (574) 293-0052
Other practice location 1
1603 N Detroit St
Warsaw, IN 46580-2273
Phone (574) 269-7377
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210422002238 | IN | Order and Referring Only - Dentist | 0143638569 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12009077A | IN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Onhealthcare, LLC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547510400000",
"number": "1508959545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "236 SIMPSON AVE",
"city": "ELKHART",
"state": "IN",
"postal_code": "465164666",
"telephone_number": "574-293-0052",
"fax_number": "574-293-3744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "236 SIMPSON AVE",
"city": "ELKHART",
"state": "IN",
"postal_code": "46516",
"telephone_number": "574-293-0052",
"fax_number": "574-293-3744"
}
],
"practiceLocations": [
{
"address_1": "1603 N Detroit St",
"address_purpose": "LOCATION",
"city": "Warsaw",
"state": "IN",
"postal_code": "465802273",
"country_code": "US",
"telephone_number": "574-269-7377",
"fax_number": "574-269-3506",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KREAGER",
"first_name": "DANIEL",
"middle_name": "NORMAN",
"name_prefix": "Mr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2019-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12009077A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elkhart, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; 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.