Organization Active NPI

Krueger Family Chiropractic, S.C.

  • Chiropractor
  • Oshkosh, WI
National Provider Identifier
1578762837
Registry record updated Oct 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
KRUEGER FAMILY CHIROPRACTIC, S.C.
Practice address
3180 Omro Rd
Oshkosh, WI 54904-9311
Phone
(920) 236-6000
Fax
(920) 236-6006
NPI assigned
Jul 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2015

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

Authorized official

Name
Dr. Jeffrey Denman Krueger, D.C.NPI 1164506564
Title
Chiropractor/President
Phone
(920) 236-6000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

3180 Omro Rd
Oshkosh, WI 54904-9311

Mailing address

3180 Omro Rd
Oshkosh, WI 54904-9311
Phone (920) 236-6000

Other identifiers 1

IdentifierTypeStateIssuer
000035991OtherWIMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070728000117 WI Part B Supplier - Clinic/Group Practice 9436250859 Receives reassigned benefits from 2 practitioners
Practice locations: Oshkosh, WI

National Provider Directory

National Provider Directory

Locations

3180 Omro Rd
Oshkosh, WI 54904
Phone (920) 236-6000

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444003200000",
    "number": "1578762837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 OMRO RD",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549049311",
            "telephone_number": "920-236-6000",
            "fax_number": "920-236-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 OMRO RD",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549049311",
            "telephone_number": "920-236-6000",
            "fax_number": "920-236-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRUEGER FAMILY CHIROPRACTIC, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-16",
        "last_updated": "2015-10-05",
        "status": "A",
        "authorized_official_last_name": "KRUEGER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "DENMAN",
        "authorized_official_title_or_position": "CHIROPRACTOR/PRESIDENT",
        "authorized_official_telephone_number": "920-236-6000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "000035991",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.