NPIMap

Individual provider Active NPI

Mary Lundgren

  • Physical Therapist
  • Orange City, IA
National Provider Identifier
1679733851
Registry record updated Jun 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1159 Issued in IA
Practice address
1000 Lincoln Cir SE
Suite 400
Orange City, IA 51041-1862
Phone
(712) 737-5234
Fax
(712) 737-5287
NPI assigned
Jun 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1159 IA Primary

Addresses

Primary practice location

1000 Lincoln Cir SE
Suite 400
Orange City, IA 51041-1862

Mailing address

1000 Lincoln Cir SE
Suite 400
Orange City, IA 51041-1862
Phone (712) 737-5234

Other names 1

  • Mary Lou Kruse Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1159IAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Health Services, Inc Past Accepting new patients
Orange City Municipal Hospital Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213142400000",
    "number": "1679733851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 LINCOLN CIR SE",
            "address_2": "SUITE 400",
            "city": "ORANGE CITY",
            "state": "IA",
            "postal_code": "510411862",
            "telephone_number": "712-737-5234",
            "fax_number": "712-737-5287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LINCOLN CIR SE",
            "address_2": "SUITE 400",
            "city": "ORANGE CITY",
            "state": "IA",
            "postal_code": "510411862",
            "telephone_number": "712-737-5234",
            "fax_number": "712-737-5287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDGREN",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2008-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "1159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "KRUSE",
            "middle_name": "LOU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orange City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; 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.