Jacqueline Marie Kronlage, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2047-IOD Issued in WV

Practice address

107 Doctors Dr
Bridgeport, WV 26330-1720

Phone

(304) 842-6226

NPI assigned

Jun 12, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WV, MN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

Southern College of Optometry, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lightbenders PLLCGroup PAC ID 0244652345, 5 clinicians

Family Vision Clinic, P.C.Group PAC ID 0446231096, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lightbenders PLLC

  • Optometrist
  • Bridgeport, WV
  • NPI 1396383907
  Medicare reassignment Care Compare group NPD
• Family Vision Clinic, P.C.

  • Optometrist
  • Savage, MN
  • NPI 1922291475
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547078400000",
    "number": "1750795365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 ORCHARD XING",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265051724",
            "telephone_number": "563-590-4998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 DOCTORS DR",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301720",
            "telephone_number": "304-842-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRONLAGE",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-12",
        "last_updated": "2019-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "073808",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WV",
            "license": "2047-IOD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Koch
• Kristie Lynn Komorowski, MS,CCC/SLP
• Jennifer Koreski
• Henderika Colinda Kremer
• Theodore D Kress, OD
• Debra Lynn Kyle
• Jason Edward Labenne, DC
• Laboratory Corporation of America Holdings
• Jeannine Marie Lafferty, MS CCCSLP
• Leslie Lagowski

• Optometrist in Bridgeport, WV
• Providers in Bridgeport, WV by specialty
• Optometrist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.