Individual provider Active NPI

Daniel Williams Kellen, DC

  • Chiropractor
  • Hiawatha, IA
National Provider Identifier
1013900398
Registry record updated Jul 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A05926 Issued in IA
Practice address
1350 Boyson Rd
BLDG C
Hiawatha, IA 52233-2211
Phone
(319) 393-0086
Fax
(319) 294-0700
NPI assigned
Aug 23, 2005
Last updated
Jul 19, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X A05926 IA Primary

Addresses

Primary practice location

1350 Boyson Rd
BLDG C
Hiawatha, IA 52233-2211

Mailing address

1350 Boyson Rd
BLDG C
Hiawatha, IA 52233-2211
Phone (319) 393-0086

Other identifiers 2

IdentifierTypeStateIssuer
52721OtherBCBS
0133280MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100903000764 IA Practitioner - Chiropractic 6608990130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1350 Boyson Rd
Suite C
Hiawatha, IA 52233-2211
Phone (319) 393-0086

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A05926IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Solutions PC Chiropractor CurrentSince Oct 17, 2002 Accepting new patients
Family Medicine and More, PLC Past Accepting new patients

Locations

1350 Boyson Rd
Bldg C
Hiawatha, IA 52233
Phone (319) 393-0086

1350 Boyson Rd
Ste C
Hiawatha, IA 52233
Phone (319) 393-0086

Organizations & group practices 2

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": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279497600000",
    "number": "1013900398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 BOYSON RD",
            "address_2": "BLDG C",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "522332211",
            "telephone_number": "319-393-0086",
            "fax_number": "319-294-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 BOYSON RD",
            "address_2": "BLDG C",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "522332211",
            "telephone_number": "319-393-0086",
            "fax_number": "319-294-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEN",
        "first_name": "DANIEL",
        "middle_name": "WILLIAMS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2010-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "52721",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0133280",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hiawatha, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.