John Andrew Kreisberg, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

00022819 Issued in AL

Practice address

400 North Edwards Street
Enterprise, AL 36330-2510

Phone

(334) 347-0584

Fax

(334) 347-2080

NPI assigned

Aug 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• QHG of Enterprise Inc

  dba Medical Center Enterprise

  • Certified Registered Nurse Anesthetist
  • Enterprise, AL
  • NPI 1295759678

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269648000000",
    "number": "1730297441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 LOUISE AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366095113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NORTH EDWARDS STREET",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302510",
            "telephone_number": "334-347-0584",
            "fax_number": "334-347-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREISBERG",
        "first_name": "JOHN",
        "middle_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2010-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "00022819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leeann McAliley Kettunen, MD
• William Kettunen, MD
• Leah Kidd, LMT
• Levi J King, FNP-C
• Stephanie Ann Kraczkowski, MED
• Kristin Huebner-SLP, LLC
• Brian Edward Kurtz, O.D.
• Celeste Marie La Salvia, OTR/L
• Carrie Leigh Labonte
• Laf Counseling Techniques, LLC

• Internal Medicine Physician in Enterprise, AL
• Providers in Enterprise, AL by specialty
• Internal Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.