Organization Active NPI

Krueger Chiropractic, Inc.

  • Rehabilitation Chiropractor
  • Lebanon, OH
National Provider Identifier
1659595189
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
1885 Issued in OH
Legal business name
KRUEGER CHIROPRACTIC, INC.
Practice address
726 E Main St
Lebanon, OH 45036-1900
Phone
(513) 933-9799
Fax
(513) 933-0866
NPI assigned
Apr 13, 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
Dr. Thomas Gerald Krueger, D.C.NPI 1578787099
Title
Chiropractor Owner
Phone
(513) 933-9799

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
Rehabilitation ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NR0400X 1885 OH Primary

Addresses

Primary practice location

726 E Main St
Lebanon, OH 45036-1900

Mailing address

726 E Main St
Lebanon, OH 45036-1900
Phone (513) 933-9799

Other identifiers 1

IdentifierTypeStateIssuer
0964587MedicaidOH

Other names 1

  • Chiropractic Sport and Spine Institute Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101217000035 OH Part B Supplier - Clinic/Group Practice 5890983803 Receives reassigned benefits from 1 practitioner
Practice locations: Lebanon, OH

National Provider Directory

National Provider Directory

Locations

726 E Main St
Ste 10
Lebanon, OH 45036
Phone (513) 933-9799

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": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659595189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 E MAIN ST",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450361900",
            "telephone_number": "513-933-9799",
            "fax_number": "513-933-0866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 E MAIN ST",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450361900",
            "telephone_number": "513-933-9799",
            "fax_number": "513-933-0866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRUEGER CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KRUEGER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "GERALD",
        "authorized_official_title_or_position": "CHIROPRACTOR OWNER",
        "authorized_official_telephone_number": "513-933-9799",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "OH",
            "license": "1885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0964587",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chiropractic Sport and Spine Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, OH

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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.