Active NPI
Brian Howard Earl Krebs
- Physician Assistant
- Fort Campbell, KY
National Provider Identifier
1962731513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 650 Joel Dr
Fort Campbell, KY 42223-5318 - Phone
- (931) 801-0377
- NPI assigned
- Dec 10, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
650 Joel Dr
Fort Campbell, KY 42223-5318
Mailing address
2179 Chester Harris Rd
Woodlawn, TN 37191-8235
Phone (931) 801-0377
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190722000586 | TN | Order and Referring Only - Physician Assistant | 6709112287 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736985600000",
"number": "1962731513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2179 CHESTER HARRIS RD",
"city": "WOODLAWN",
"state": "TN",
"postal_code": "371918235",
"telephone_number": "931-801-0377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 JOEL DR",
"city": "FORT CAMPBELL",
"state": "KY",
"postal_code": "422235318",
"telephone_number": "931-801-0377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KREBS",
"first_name": "BRIAN",
"middle_name": "HOWARD EARL",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-12-10",
"last_updated": "2025-01-16",
"certification_date": "2025-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Campbell, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.