Organization Active NPI

Kruse Chiropractic, PLLC

  • Chiropractor
  • Rolesville, NC
National Provider Identifier
1861013302
Registry record updated May 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
KRUSE CHIROPRACTIC, PLLC
Practice address
6360 Rogers Rd
Rolesville, NC 27571-9371
Phone
(919) 435-7020
Fax
(919) 435-7134
NPI assigned
May 6, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2020

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

Authorized official

Name
Lucas Wayne Kruse, D.C.NPI 1790986016
Title
Chiropractor
Phone
(919) 435-7020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

6360 Rogers Rd
Rolesville, NC 27571-9371

Mailing address

6360 Rogers Rd
Rolesville, NC 27571-9371
Phone (919) 435-7020

Other names 1

  • Kruse Chiropractic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200623002793 NC Part B Supplier - Clinic/Group Practice 2860814795 Receives reassigned benefits from 1 practitioner
Practice locations: Rolesville, NC

National Provider Directory

National Provider Directory

Locations

6360 Rogers Rd
Rolesville, NC 27571
Phone (919) 435-7020

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1588723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588723200000",
    "number": "1861013302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6360 ROGERS RD",
            "city": "ROLESVILLE",
            "state": "NC",
            "postal_code": "275719371",
            "telephone_number": "919-435-7020",
            "fax_number": "919-435-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6360 ROGERS RD",
            "city": "ROLESVILLE",
            "state": "NC",
            "postal_code": "275719371",
            "telephone_number": "919-435-7020",
            "fax_number": "919-435-7134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRUSE CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-06",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A",
        "authorized_official_last_name": "KRUSE",
        "authorized_official_first_name": "LUCAS",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "919-435-7020",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kruse Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rolesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.