Kevan D. Kruse, DC

Primary specialty

Nutrition ChiropractorTaxonomy code 111NN1001X

License

CH 6698 Issued in FL

Practice address

641 W Lumsden Rd
Brandon, FL 33511-5911

Phone

(813) 654-5413

Fax

(813) 643-1457

NPI assigned

Jul 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Absolute Wellness CenterGroup PAC ID 2163679523, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Absolute Wellness Center, LLC

  dba Absolute Wellness Center

  • Nutrition Chiropractor
  • Brandon, FL
  • NPI 1265629745
  Medicare reassignment Care Compare group NPD
• Axis Chiropractic & Rehab Center, Inc

  • Chiropractor
  • Tampa, FL
  • NPI 1528237518
  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346371200000",
    "number": "1861422677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 W LUMSDEN RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115911",
            "telephone_number": "813-654-5413",
            "fax_number": "813-643-1457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 W LUMSDEN RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115911",
            "telephone_number": "813-654-5413",
            "fax_number": "813-643-1457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "KEVAN",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2012-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "FL",
            "license": "CH 6698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3815919-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Krueger, BCABA
• Ryan Jay Krumins
• Linda Krupa, LMT
• Kruse Consulting Inc
• Benjamin Kruse, PTA
• Steven John Kruse, PH.D.
• Abigail Kubasky
• Jennifer Kudja-Rennick, MD
• Sophia Renee Kuhn, SLPA
• Shevin Kulangara

• Nutrition Chiropractor in Brandon, FL
• Providers in Brandon, FL by specialty
• Nutrition Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.