Individual provider Active NPI

Terese Nickol Kruse, PHARMD.

  • Pharmacist
  • Dubuque, IA
National Provider Identifier
1992823678
Registry record updated Jan 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
20434 Issued in IA
Practice address
1920 Elm St
Dubuque, IA 52001-3641
Phone
(563) 589-8970
NPI assigned
Mar 27, 2007
Last updated
Jan 12, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 20434 IA Primary

Addresses

Primary practice location

1920 Elm St
Dubuque, IA 52001-3641

Mailing address

1920 Elm St
Dubuque, IA 52001-3641
Phone (563) 589-8970

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
20434IAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Family Pharmacy 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294790400000",
    "number": "1992823678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 ELM ST",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520013641",
            "telephone_number": "563-589-8970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 ELM ST",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520013641",
            "telephone_number": "563-589-8970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "TERESE",
        "middle_name": "NICKOL",
        "name_prefix": "Dr.",
        "credential": "PHARMD.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2011-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "20434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2011; 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.