Individual provider Active NPI

Judi A Krogstad, M.D.

  • Pediatrics Physician
  • Fresno, CA
National Provider Identifier
1730196304
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G072335 Issued in CA
Practice address
7085 N Whitney Ave Ste 101
Fresno, CA 93720-8029
Phone
(559) 437-7338
Fax
(559) 437-7153
NPI assigned
Aug 3, 2006
Last updated
Jun 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X G072335 CA
Pediatrics Physician 208000000X G072335 CA Primary

Addresses

Primary practice location

7085 N Whitney Ave Ste 101
Fresno, CA 93720-8029

Mailing address

PO Box 28949
Fresno, CA 93729-8949
Phone (559) 228-5400

Other practice location 1

7050 N Recreation Ave
#102
Fresno, CA 93720-8001
Phone (559) 322-2900

Other identifiers 1

IdentifierTypeStateIssuer
00G723350OtherCASTATE ID

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G072335CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1730196304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28949",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937298949",
            "telephone_number": "559-228-5400",
            "fax_number": "559-228-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7085 N WHITNEY AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937208029",
            "telephone_number": "559-437-7338",
            "fax_number": "559-437-7153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7050 N Recreation Ave",
            "address_2": "#102",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937208001",
            "country_code": "US",
            "telephone_number": "559-322-2900",
            "fax_number": "559-322-2901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KROGSTAD",
        "first_name": "JUDI",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "G072335",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G072335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE ID",
            "identifier": "00G723350",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.