{
"Npi": {
"NPI": "1649916248",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "KRUSE",
"FirstName": "LAUREN",
"MiddleName": "ELIZABETH",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "DO",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 959203",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAINT LOUIS",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "63195-9203",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "618-257-6220",
"MailingAddressFaxNumber": "618-257-6679",
"FirstLinePracticeLocationAddress": "4500 MEMORIAL DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BELLEVILLE",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "62226-5360",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "618-463-8500",
"PracticeLocationAddressFaxNumber": "618-257-6220",
"EnumerationDate": "05/07/2022",
"LastUpdateDate": "12/18/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "8288",
"LicenseNumberStateCode": "OK",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "208M00000X",
"TaxonomyName": "Hospitalist Physician",
"LicenseNumber": "036177751",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}