Individual provider Active NPI

Bruce W Krell, DPM

  • Foot & Ankle Surgery Podiatrist
  • Chandler, AZ
National Provider Identifier
1831149103
Registry record updated Jan 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
AZ00316 Issued in AZ
Practice address
725 S Dobson Rd
Ste 203
Chandler, AZ 85224-5680
Phone
(480) 807-8532
Fax
(480) 807-0420
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 0316 AZ
Foot & Ankle Surgery Podiatrist 213ES0103X AZ00316 AZ Primary

Addresses

Primary practice location

725 S Dobson Rd
Ste 203
Chandler, AZ 85224-5680

Mailing address

725 S Dobson Rd
Ste 203
Chandler, AZ 85224-5680
Phone (480) 807-8532

Other identifiers 3

IdentifierTypeStateIssuer
AZ0191480OtherAZBLUE CROSS/BLUE SHIELD
69965001MedicaidAZ
609973800OtherAZDEPT OF LABOR OWCP

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0316AZMDFoot & Ankle Surgery Podiatrist
AZ00316AZMDFoot & Ankle Surgery Podiatrist

Interoperability endpoints

  • Direct secure messaging: bkrell@direct.uspi.com

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390867200000",
    "number": "1831149103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 S DOBSON RD",
            "address_2": "STE 203",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245680",
            "telephone_number": "480-807-8532",
            "fax_number": "480-807-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S DOBSON RD",
            "address_2": "STE 203",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245680",
            "telephone_number": "480-807-8532",
            "fax_number": "480-807-0420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRELL",
        "first_name": "BRUCE",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2014-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AZ",
            "license": "0316",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AZ",
            "license": "AZ00316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "AZ0191480",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "69965001",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR  OWCP",
            "identifier": "609973800",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; 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.