Individual provider Active NPI

Marisa Ann Atria Kruger, O.D.

  • Vision Therapy Optometrist
  • Lakewood, CO
National Provider Identifier
1912969056
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
License
99142899 Issued in CO
Practice address
165 S Union Blvd
#460
Lakewood, CO 80228-2215
Phone
(303) 865-4290
Fax
(303) 865-4294
NPI assigned
Apr 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vision Therapy Optometrist 152WV0400X 99142899 CO Primary

Addresses

Primary practice location

165 S Union Blvd
#460
Lakewood, CO 80228-2215

Mailing address

165 S Union Blvd
460
Lakewood, CO 80228-2215
Phone (303) 865-4290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
99142899COMDVision Therapy Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dorothy M Parrott Vision Therapy Past Accepting new patients

Organizations & group practices 1

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": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196208000000",
    "number": "1912969056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 S UNION BLVD",
            "address_2": "460",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802282215",
            "telephone_number": "303-865-4290",
            "fax_number": "303-865-4294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 S UNION BLVD",
            "address_2": "#460",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802282215",
            "telephone_number": "303-865-4290",
            "fax_number": "303-865-4294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATRIA KRUGER",
        "first_name": "MARISA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-04",
        "last_updated": "2007-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "CO",
            "license": "99142899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.