Individual provider Active NPI

Katherine Erin Kruger, NP

  • Acute Care Nurse Practitioner
  • Dededo, GU
National Provider Identifier
1912246174
Registry record updated Jul 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
NP0138 Issued in GU
Practice address
133 Route 3
Dededo, GU 96929
Phone
(671) 645-5500
NPI assigned
Feb 7, 2013
Last updated
Jul 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1344 AK
Family Nurse Practitioner 363LF0000X 1344 AK
Acute Care Nurse Practitioner 363LA2100X NP0138 GU Primary

Addresses

Primary practice location

133 Route 3
Dededo, GU 96929

Mailing address

425 Chalan San Antonio
PMB 622
Tamuning, GU 96913-3516
Phone (671) 488-8176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140815000310 TX Practitioner - Nurse Practitioner 0244457240 Reassigns benefits to 1 organization
I20220118001501 MI Practitioner - Nurse Practitioner 0244457240 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chelsea Community Hospital CurrentSince Feb 1, 2023 Accepting new patients
Observation Medicine Group PLLC CurrentSince Jan 12, 2022 Accepting new patients
Emergency Medicine Physicians of Genesee County, PLLC CurrentSince Jan 12, 2022 Accepting new patients
Epmg of Michigan, P.C. CurrentSince Jan 16, 2022 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Apr 15, 2014 Accepting new patients
Chelsea Community Hospital Current Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

775 S Main St
Chelsea, MI 48118
Phone (313) 995-3764

1 Genesys Pkwy
Grand Blanc, MI 48439
Phone (810) 606-5733

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

2333 Biddle Ave
Wyandotte, MI 48192
Phone (734) 246-6000

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1360195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530748800000",
    "number": "1912246174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 CHALAN SAN ANTONIO",
            "address_2": "PMB 622",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133516",
            "telephone_number": "671-488-8176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 ROUTE 3",
            "city": "DEDEDO",
            "state": "GU",
            "postal_code": "96929",
            "telephone_number": "671-645-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUGER",
        "first_name": "KATHERINE",
        "middle_name": "ERIN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-07",
        "last_updated": "2018-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AK",
            "license": "1344",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "1344",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GU",
            "license": "NP0138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dededo, GU

Sources for this page

Verify at the official NPI Registry.