Individual provider Active NPI

Kristina Breitling Krug, NCPS, CRPS

  • Personal Care Attendant
  • Fleming Island, FL
National Provider Identifier
1932679420
Registry record updated Jan 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
Practice address
1735 Moss Creek Dr
Fleming Island, FL 32003-8348
Phone
(904) 646-6392
NPI assigned
Nov 28, 2018
Last updated
Jan 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Psychologist 103TF0000X
Personal Care Attendant 3747P1801X Primary
Peer Specialist 175T00000X 549 FL

Addresses

Primary practice location

1735 Moss Creek Dr
Fleming Island, FL 32003-8348

Mailing address

1735 Moss Creek Dr
Fleming Island, FL 32003-8348
Phone (904) 646-6392

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
549FLMDAddiction (Substance Use Disorder) Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1543363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548374400000",
    "number": "1932679420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 MOSS CREEK DR",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320038348",
            "telephone_number": "904-646-6392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 MOSS CREEK DR",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320038348",
            "telephone_number": "904-646-6392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUG",
        "first_name": "KRISTINA",
        "middle_name": "BREITLING",
        "name_prefix": "Mrs.",
        "credential": "NCPS, CRPS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-28",
        "last_updated": "2019-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "FL",
            "license": "549",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fleming Island, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2019; 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.