KENNETH J KRUEGER (NPI# 1538159231) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538159231 |
| Entity Type | Individual |
| Full Name | KENNETH J KRUEGER |
| Credential | DPM |
| Practice Address |
4725 Statesmen Dr Ste A Indianapolis IN 46250-5645 |
| Practice Telephone | 3177131111 |
| Practice Fax Number | 3177131100 |
| Mailing Telephone | 3177131111 |
| Mailing Fax Number | 3177131100 |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2018-04-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 07000391A | IN | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100060080 | 05 | |
| IN | ANTHEM BLUE CROSS AND BLUE SHIELD | 000000344455 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134132269 | Kenneth R. Krueger | Dentist | 4118 Mccullough Ave Ste 4, San Antonio, TX 78212-1905 | 2006-08-13 |
| 1780128934 | Kenneth Dayton Krueger | Counselor | 1942 E Cantrell St, Decatur, IL 62521-3214 | 2016-12-07 |
| Street Address |
4725 STATESMEN DR STE A |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46250-5645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861037004 | Angela L Davis | Pharmacist | 8520 Bash St, Indianapolis, IN 46250 | 2019-11-12 |
| 1710455738 | Physicians Wellness Associates LLC | Family Medicine | 4735 Statesmen Drive, Suite C, Indianapolis, IN 46250 | 2018-11-07 |
| 1891222584 | Confidential Drug LLC | Pharmacy | 8520 Bash St Ste D, Indianapolis, IN 46250 | 2017-05-12 |
| 1659813590 | Occupational Health Centers of The Southwest Pa | Clinic/Center | 8257 Center Run Rd, Indianapolis, IN 46250 | 2016-11-09 |
| 1194275669 | Lucina Treatment Center, LLC | Internal Medicine | 8140 Castleton Rd, Indianapolis, IN 46250 | 2016-10-09 |
| 1609126150 | Joseph Lee Deck | Physical Therapist | 7400 Jewel Lane, Indianapolis, IN 46250 | 2012-09-12 |
| 1447508254 | Choices Coordinated Care Solutions, Inc. | Clinic/Center | 7941 Castleway Drive, Indianapolis, IN 46250 | 2012-08-28 |
| 1568719854 | Lynda L. Blackwelder, LLC | Marriage & Family Therapist | 4735 Statesmen Dr., Suite A, Indianapolis, IN 46250 | 2012-08-06 |
| 1972859452 | Courtney B. Cortez | Nurse Practitioner | 12400 N Meridian Ste 100, Suite 500, Indianapolis, IN 46250 | 2012-08-02 |
| 1861761934 | Kb Medical, Inc. | Durable Medical Equipment & Medical Supplies | 8455, Castlewood Drive, Suite J, Idianapolis, IN 46250 | 2011-12-20 |
| Find all providers in zip 46250 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194107607 | Mark Wavrunek | Podiatrist | 161 Washington Pointe Dr, Indianapolis, IN 46229-2693 | 2015-06-19 |
| 1639300486 | Paul M Kanter | Podiatrist | 348 Woodrow Ave, Indianapolis, IN 46241-0828 | 2009-07-28 |
| 1629208103 | Kenneth P Stumpf | Podiatrist | 6626 E 75th St, Ste 500, Indianapolis, IN 46250-2805 | 2009-07-20 |
| 1992960124 | Eugenia C Malenkos | Podiatrist | 1410 West 10th Street, Indianapolis, IN 46202-1616 | 2008-07-28 |
| 1740457555 | Lake Mi Mobile Doctors, P.C. | Podiatrist | 3388 Founders Rd, Suite C, Indianapolis, IN 46268-1443 | 2008-05-12 |
| 1093988263 | Jeremy Patrick Spaulding | Podiatrist | 8128 E Washington St, Indianapolis, IN 46219-6814 | 2008-04-09 |
| 1306018767 | Robert S. Mandresh Dpm PC Inc | Podiatrist | 8330 Naab Rd Ste 135, Indianapolis, IN 46260-1932 | 2008-03-26 |
| 1285837773 | Beech Grove Foot Care Inc | Podiatrist | 7855 S. Emerson Ave, Suite T, Indianapolis, IN 46237 | 2007-06-11 |
| 1366589467 | Indianapolis Osteopathic Hospital Inc. | Podiatrist | 3520 Guion Rd Suite 204, Indianapolis, IN 46222 | 2007-01-30 |
| 1447329826 | Thomas Wayne Zunica | Podiatrist | 3901 Meadows Dr, Indianapolis, IN 46205-3113 | 2006-11-07 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46250 |
Please comment or provide details below to improve the information on KENNETH J KRUEGER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.