Individual provider Active NPI

Melinda Natasha Kruger Kruger, NP-C

  • Family Nurse Practitioner
  • Edmond, OK
National Provider Identifier
1851741052
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F06161439 Issued in OK
Practice address
1221 N Kelly Ave
Edmond, OK 73003-4865
Phone
(405) 844-1663
Fax
(405) 285-4060
NPI assigned
Jun 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0106037 OK
Family Nurse Practitioner 363LF0000X F06161439 OK Primary

Addresses

Primary practice location

1221 N Kelly Ave
Edmond, OK 73003-4865

Mailing address

228 S Bryant Ave
# 8
Edmond, OK 73034-5723
Phone (405) 938-1389

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170125002488 OK Practitioner - Nurse Practitioner 5092097196 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Oklahoma Ambulatory Services LLC 43 clinicians

Practice addresses (Care Compare)

228 S Bryant Ave
Suite 8
Edmond, OK 73034-5723
Phone (405) 938-1389

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0106037OKMDRegistered Nurse
F06161439OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Oklahoma Ambulatory Services LLC CurrentSince Jul 25, 2022 Accepting new patients
Advance Physicians Group CurrentSince Dec 13, 2016 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

1380 W Covell Rd
Ste 132
Edmond, OK 73003
Phone (405) 279-9637

228 S Bryant Ave
#8
Edmond, OK 73034
Phone (405) 938-1389

1221 N Kelly Ave
Edmond, OK 73003
Phone (405) 285-8799

4510 NW 39th St
Oklahoma City, OK 73122
Phone (405) 495-5841

Organizations & group practices 3

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": "1466121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1851741052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 S BRYANT AVE",
            "address_2": "# 8",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730345723",
            "telephone_number": "405-938-1389",
            "fax_number": "405-938-1388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 N KELLY AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730034865",
            "telephone_number": "405-844-1663",
            "fax_number": "405-285-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUGER",
        "first_name": "MELINDA",
        "middle_name": "NATASHA KRUGER",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-17",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "0106037",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "F06161439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.