NPIMap

Organization Active NPI

Kreg Therapeutics, Inc.

  • Customized Equipment (DME)
  • South Bend, IN
National Provider Identifier
1831382654
Registry record updated Aug 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Legal business name
KREG THERAPEUTICS, INC.
Practice address
1905 Goodson CT
South Bend, IN 46613-3413
Phone
(312) 829-8904
Fax
(312) 829-8909
NPI assigned
Aug 24, 2007
Last updated
Aug 24, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2007

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

Authorized official

Name
Mrs. Maria I Mayorga
Title
Medicare Biller
Phone
(312) 829-8904

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X NU Primary

Addresses

Primary practice location

1905 Goodson CT
South Bend, IN 46613-3413

Mailing address

2240 W Walnut St
Chicago, IL 60612-2218
Phone (312) 829-8904

National Provider Directory

National Provider Directory
Tax ID family
Kreg Therapeutics Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1905 Goodson Ct
South Bend, IN 46613
Phone (312) 829-8904

NPI Registry JSON

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

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187913600000",
    "number": "1831382654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 W WALNUT ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122218",
            "telephone_number": "312-829-8904",
            "fax_number": "312-829-8909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 GOODSON CT",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466133413",
            "telephone_number": "312-829-8904",
            "fax_number": "312-829-8909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KREG THERAPEUTICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-24",
        "last_updated": "2007-08-24",
        "status": "A",
        "authorized_official_last_name": "MAYORGA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "MEDICARE BILLER",
        "authorized_official_telephone_number": "312-829-8904",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2007; 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.