Organization Active NPI

Daniel E. Kruger, LLC

  • Clinical Psychologist
  • Tucson, AZ
National Provider Identifier
1619009107
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3667 Issued in AZ
Legal business name
DANIEL E. KRUGER, LLC
Practice address
6612 E Carondelet Dr
Tucson, AZ 85710-2119
Phone
(520) 981-2511
Fax
(520) 514-5233
NPI assigned
Mar 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Daniel E Kruger, PHDNPI 1205820164
Title
Owner
Phone
(520) 981-2511

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
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 3667 AZ Primary

Addresses

Primary practice location

6612 E Carondelet Dr
Tucson, AZ 85710-2119

Mailing address

5635 E Holmes St
Tucson, AZ 85711-2447
Phone (520) 981-2511

Other identifiers 1

IdentifierTypeStateIssuer
886020MedicaidAZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1173484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619009107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5635 E HOLMES ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112447",
            "telephone_number": "520-981-2511",
            "fax_number": "520-514-5233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6612 E CARONDELET DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857102119",
            "telephone_number": "520-981-2511",
            "fax_number": "520-514-5233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL E. KRUGER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KRUGER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-981-2511",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "3667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "886020",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.