Active NPI
John E Kruger, O.D.
- Optometrist
- Ames, IA
National Provider Identifier
1548253586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1623
- Practice address
- 201 10TH St
Ames, IA 50010-6211 - Phone
- (515) 232-3451
- Fax
- (515) 233-4886
- NPI assigned
- Aug 24, 2005
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1623 | IA | Primary |
| Corneal and Contact Management Optometrist | 152WC0802X | 1623 | IA | |
| Pediatric Optometrist | 152WP0200X | 1623 | IA | |
| Sports Vision Optometrist | 152WS0006X | 1623 | IA | |
| Vision Therapy Optometrist | 152WV0400X | 1623 | IA |
Addresses
Primary practice location
201 10TH St
Ames, IA 50010-6211
Mailing address
201 10TH St
Ames, IA 50010-6211
Phone (515) 232-3451
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0129726 | Medicaid | IA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1623 | IA | MD | Vision Therapy Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192665600000",
"number": "1548253586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 10TH ST",
"city": "AMES",
"state": "IA",
"postal_code": "500106211",
"telephone_number": "515-232-3451",
"fax_number": "515-233-4886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 10TH ST",
"city": "AMES",
"state": "IA",
"postal_code": "500106211",
"telephone_number": "515-232-3451",
"fax_number": "515-233-4886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUGER",
"first_name": "JOHN",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-24",
"last_updated": "2007-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IA",
"license": "1623",
"primary": true
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "IA",
"license": "1623",
"primary": false
},
{
"code": "152WP0200X",
"taxonomy_group": "",
"desc": "Optometrist, Pediatrics",
"state": "IA",
"license": "1623",
"primary": false
},
{
"code": "152WS0006X",
"taxonomy_group": "",
"desc": "Optometrist, Sports Vision",
"state": "IA",
"license": "1623",
"primary": false
},
{
"code": "152WV0400X",
"taxonomy_group": "",
"desc": "Optometrist, Vision Therapy",
"state": "IA",
"license": "1623",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0129726",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ames, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.