Michaela Ann Kruse, MA, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164.006418 Issued in IL

Practice address

2906 Crossing CT
Champaign, IL 61822-6163

Phone

(217) 356-6543

Fax

(217) 366-0037

NPI assigned

Jun 25, 2010

Last updated

Mar 18, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1629389515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2906 CROSSING CT",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618226163",
            "telephone_number": "217-356-6543",
            "fax_number": "217-366-0037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2906 CROSSING CT",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618226163",
            "telephone_number": "217-356-6543",
            "fax_number": "217-366-0037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "MICHAELA",
        "middle_name": "ANN",
        "credential": "MA, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-25",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.006418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clinton Krewson, PA
• Michelle Dawn Krieger, LPC
• Tangella V. Krishnarao, M.D.
• Julieann Krogel, PH.D.
• Devon Kruse-Wu
• Allison T Krutul, PSYD
• Kshep Counseling PLLC
• Mary Kubalanza
• Carlene Marie Kudrick
• Marcy Kujawski, MSW, LCSW

• Registered Dietitian in Champaign, IL
• Providers in Champaign, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; 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.