Jessica Nicole Krueger, CTRS

Primary specialty

Recreation TherapistTaxonomy code 225800000X

License

80094 Issued in MI

Practice address

2348 W Samaria Rd
Temperance, MI 48182-9738

Phone

(517) 918-0441

NPI assigned

Jul 6, 2023

Sex

Female

Sole proprietor

Yes

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, last updated by the provider on Jul 6, 2023.

{
    "created_epoch": "1688601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1639857006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2348 W SAMARIA RD",
            "city": "TEMPERANCE",
            "state": "MI",
            "postal_code": "481829738",
            "telephone_number": "517-918-0441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2348 W SAMARIA RD",
            "city": "TEMPERANCE",
            "state": "MI",
            "postal_code": "481829738",
            "telephone_number": "517-918-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "CTRS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-06",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": "MI",
            "license": "80094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy J. Kirk, R.PH.
• Jenna Elizabeth Klump, FNP-C
• Caroline Kobbah
• Mark Thomas Koehl, M.D.
• Candace Kovar
• Daryl Lee Lajiness, D.C.
• Reyna Linette Lajiness, D.C.
• Lake Erie Medical & Surgical Supply, Inc
• Joseph A. Lascala, DC
• Melissa Ann Lemay, RN

• All providers in Temperance, MI
• Recreation Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; 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.