Jeffrey T Krogstad, MD
Individual provider Active NPI Family Medicine Physician · Olivia, MN
NPI 1972579696 · NPPES record last updated Apr 2, 2015
Key facts
- NPI
- 1972579696
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 26657 (MN)
- Practice address
- 611 E Fairview Ave
Olivia, MN 56277-4213 - Phone
- (320) 523-1460
- Fax
- (320) 523-8349
- NPI assigned
- Feb 23, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Interoperability endpoints
- jeffrey.krogstad@avera.sdhealthlink.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 26657 | MN | Yes |
Addresses
Primary practice location
611 E Fairview Ave
Olivia, MN 56277-4213
Mailing address
611 E Fairview Ave
Olivia, MN 56277-4213
Phone (320) 523-1460
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 032708500 | Medicaid | MN |
Other providers in Olivia, MN
- Independent School District No 2534
- Anna Elizabeth Johansen
- Kandiyohi-Renville Community Health Board
- Jon R Kemp
- Roberta Lynn Kopel
- Laura Weatherby PLLC
- Benjamin August Linder
- Gary Lohmeyer
- Valarie Longhin
- Danelle Loomis
All providers in Olivia, MN · Family Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.