Mandy M Krug, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2887 Issued in NC

Practice address

2424 W Mallard Creek Church Rd
Ste D
Charlotte, NC 28262-2326

Phone

(704) 295-0123

NPI assigned

Aug 1, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1343779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407801600000",
    "number": "1649526229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 W MALLARD CREEK CHURCH RD",
            "address_2": "STE D",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282622326",
            "telephone_number": "704-295-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 W MALLARD CREEK CHURCH RD",
            "address_2": "STE D",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282622326",
            "telephone_number": "704-295-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUG",
        "first_name": "MANDY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-01",
        "last_updated": "2014-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1726",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5921530",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krowned and Kultured LLC
• Collin James Kruczek, PHARMD
• Erin Harkins Krueger, DPT
• Eva Krug, LCSW
• Joseph Hoffmann Krug Jr., MD
• Erica Krul
• Tracey Chapin Krumel, AU.D.
• Emily Marie Krupa
• Rebekah Joy Krupski, PHARMD
• Caitlin Emily Krusen, PA-C

• Optometrist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2014; 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.