Jeremy Krekula

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

304745 Issued in MN

Practice address

102 Main St N Ste 100
Stewartville, MN 55976-2608

Phone

(507) 218-7114

NPI assigned

Oct 7, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jeremy Erwin Danie Krekula Professional name

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1598362014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MAIN ST N STE 100",
            "city": "STEWARTVILLE",
            "state": "MN",
            "postal_code": "559762608",
            "telephone_number": "507-218-7114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MAIN ST N STE 100",
            "city": "STEWARTVILLE",
            "state": "MN",
            "postal_code": "559762608",
            "telephone_number": "507-218-7114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREKULA",
        "first_name": "JEREMY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-07",
        "last_updated": "2020-10-07",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "304745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA BOARD OF BEHAVIOAL HEALTH",
            "identifier": "304745",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.liferenewalcenter.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "200 6th St NW",
            "city": "Byron",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559201334",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Therapynotes.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "102 Main St N Ste 100",
            "city": "Stewartville",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559762608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JEREMY",
            "last_name": "KREKULA",
            "middle_name": "ERWIN DANIE",
            "credential": "LADC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Hy-Vee Inc
• Ind School Dist 534
• Isd #534 Stewartville Public Schools
• Jennifer L Peterson
• Leroy Johnson Jr.
• Michael George Kuderer, D.C.
• Zachary John Lechner, D.D.S.
• Stephanie Christine Lillis, D.C.
• Lindsey Lilly
• Nicole Marie Lonien, M.S. CCC-SLP

• Addiction (Substance Use Disorder) Counselor in Stewartville, MN
• Providers in Stewartville, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.