KJG LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0105260 Issued in KS

Legal business name

KJG LLC

Practice address

430 Main St
Wellsville, KS 66092-0726

Phone

(785) 883-9355

Fax

(785) 883-4030

NPI assigned

May 21, 2015

Organization subpart

No

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

Authorized official

Name

Kristina Jeanne Gibbons, D.C.NPI 1851548309

Title

Managing Member

Phone

(785) 883-9355

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Family Life Chiropractic & Wellness Doing business as

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kristina Jeanne Gibbons, D.C.

  • Chiropractor
  • Wellsville, KS
  • NPI 1851548309
  Medicare reassignment NPD Authorized official
• Carson Smith

  • Chiropractor
  • Wellsville, KS
  • NPI 1740130152
  NPD

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

{
    "created_epoch": "1432166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587513600000",
    "number": "1013396209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 MAIN ST",
            "address_2": "PO BOX 726",
            "city": "WELLSVILLE",
            "state": "KS",
            "postal_code": "660928878",
            "telephone_number": "785-883-9355",
            "fax_number": "785-883-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 MAIN ST",
            "city": "WELLSVILLE",
            "state": "KS",
            "postal_code": "660920726",
            "telephone_number": "785-883-9355",
            "fax_number": "785-883-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KJG LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-21",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A",
        "authorized_official_last_name": "GIBBONS",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_middle_name": "JEANNE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "785-883-9355",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "0105260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1851548309",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Life Chiropractic & Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Life Chiropractic & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa A Burton, OTA
• CJSF LLC
• Marisa Donovan
• Kristina Jeanne Gibbons, D.C.
• Kathleen Johnson
• Kelsey Nicole Lewis, APRN
• Madison Lopez, DC
• Teresa J Manes, OTR
• Markleysburg Healthcare Investors, L.P.
• Ryan McHugh, B.S.

• Chiropractor in Wellsville, KS
• Providers in Wellsville, KS by specialty
• Chiropractor in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.