Individual provider Active NPI

John Krug, PT

  • Physical Therapist
  • Crown Point, IN
National Provider Identifier
1588970982
Registry record updated Aug 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05001166A Issued in IN
Practice address
60 W 94TH PL
Crown Point, IN 46307-1710
Phone
(219) 661-9508
Fax
(219) 661-9509
NPI assigned
Aug 23, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05001166A IN Primary

Addresses

Primary practice location

60 W 94TH PL
Crown Point, IN 46307-1710

Mailing address

60 W 94TH PL
Crown Point, IN 46307-1710
Phone (219) 661-9508

Other identifiers 1

IdentifierTypeStateIssuer
100326590MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171010003214 IN Practitioner - Physical Therapist in Private Practice 8628084514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

343 E 90TH Dr
Merrillville, IN 46410-8152
Phone (219) 207-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05001166AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Aug 1, 2017 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Aug 1, 2017 Accepting new patients
Innovative Physical Therapy LLC Physical Therapist PastSince Jan 1, 2016 Accepting new patients
Procare Physical Therapy, P.C. Physical Therapist PastSince Apr 1, 1990 Accepting new patients

Locations

2500 W Kilgore Ave
Muncie, IN 47304
Phone (765) 201-7878

536 Old Howell Rd
Greenville, SC 29615
Phone (877) 508-3237

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1282521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282521600000",
    "number": "1588970982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 W 94TH PL",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463071710",
            "telephone_number": "219-661-9508",
            "fax_number": "219-661-9509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 W 94TH PL",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463071710",
            "telephone_number": "219-661-9508",
            "fax_number": "219-661-9509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUG",
        "first_name": "JOHN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-23",
        "last_updated": "2010-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05001166A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100326590",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.