Individual provider Active NPI

Olivia Kruger, CNM

  • Advanced Practice Midwife
  • Stafford, VA
National Provider Identifier
1831941830
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
0024189840 Issued in VA
Practice address
955 E Wonder Rd
Stafford, VA 22554
Phone
(540) 741-7892
Fax
(540) 741-9778
NPI assigned
Apr 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 0024189840 VA Primary

Addresses

Primary practice location

955 E Wonder Rd
Stafford, VA 22554

Mailing address

2076 Percheron Dr
King George, VA 22485-6776
Phone (760) 473-4967

Other practice location 1

2076 Percheron Dr
King George, VA 22485-6776
Phone (760) 473-4967

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240827002865 VA Practitioner - Certified Nurse Midwife (CNM) 3173062759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Washington Healthcare PhysiciansGroup PAC ID 2769546530, 286 clinicians

Practice addresses (Care Compare)

955 -D Wonder Rd
Stafford, VA 22554-7798
Phone (540) 741-7892

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
0024189840VAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Healthcare Physicians CurrentSince Jul 15, 2024 Accepting new patients
Mary Washington Healthcare Physicians CurrentSince Jul 15, 2024 Accepting new patients

Locations

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

955 Wonder Rd
Ste E
Stafford, VA 22554
Phone (540) 741-7892

955 Wonder Rd
Stafford, VA 22554
Phone (540) 741-7892

Interoperability endpoints

  • Direct secure messaging: okruger121914@marywashingtonhealthcare.direct-ci.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1831941830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2076 PERCHERON DR",
            "city": "KING GEORGE",
            "state": "VA",
            "postal_code": "224856776",
            "telephone_number": "760-473-4967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 E WONDER RD",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "22554",
            "telephone_number": "540-741-7892",
            "fax_number": "540-741-9778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2076 Percheron Dr",
            "address_purpose": "LOCATION",
            "city": "King George",
            "state": "VA",
            "postal_code": "224856776",
            "country_code": "US",
            "telephone_number": "760-473-4967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRUGER",
        "first_name": "OLIVIA",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-03",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "VA",
            "license": "0024189840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, VA

Sources for this page

Verify at the official NPI Registry.