Individual provider Active NPI

Deborah Kelly Krueger, OTR/L

  • Occupational Therapist
  • Saint Cloud, MN
National Provider Identifier
1992813000
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
101489 Issued in MN
Practice address
4801 Veterans Dr
Mh116A1
Saint Cloud, MN 56303-2015
Phone
(320) 255-6480
Fax
(320) 255-6472
NPI assigned
Aug 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 101489 MN Primary

Addresses

Primary practice location

4801 Veterans Dr
Mh116A1
Saint Cloud, MN 56303-2015

Mailing address

29457 Kale CT
Saint Joseph, MN 56374-9605
Phone (320) 260-5549

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
101489MNMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992813000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29457 KALE CT",
            "city": "SAINT JOSEPH",
            "state": "MN",
            "postal_code": "563749605",
            "telephone_number": "320-260-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 VETERANS DR",
            "address_2": "MH116A1",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032015",
            "telephone_number": "320-255-6480",
            "fax_number": "320-255-6472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "DEBORAH",
        "middle_name": "KELLY",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "101489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.