Individual provider Active NPI

Sarah June Lindholm Kruis, DC

  • Chiropractor
  • Elkhart, IN
National Provider Identifier
1720747900
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08003273A Issued in IN
Practice address
625 E Bristol St
Elkhart, IN 46514-3476
Phone
(574) 262-4402
NPI assigned
Dec 15, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 08003273A IN Primary

Addresses

Primary practice location

625 E Bristol St
Elkhart, IN 46514-3476

Mailing address

625 E Bristol St
Elkhart, IN 46514-3476
Phone (574) 262-4402

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211216001446 IN Practitioner - Chiropractic 1759772247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Lindholm Chiropractic PCGroup PAC ID 0042498966, 4 clinicians

Practice addresses (Care Compare)

625 E Bristol St
Elkhart, IN 46514-3476

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1639526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1720747900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 E BRISTOL ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465143476",
            "telephone_number": "574-262-4402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 E BRISTOL ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465143476",
            "telephone_number": "574-262-4402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUIS",
        "first_name": "SARAH",
        "middle_name": "JUNE LINDHOLM",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-15",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08003273A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.