Individual provider Active NPI

Kevin Karl Gansert, D.C.

  • Chiropractor
  • Ontario, CA
National Provider Identifier
1043274087
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC25567 Issued in CA
Practice address
601 N Euclid Ave
Ontario, CA 91762-3223
Phone
(626) 852-2268
Fax
(909) 687-2622
NPI assigned
Apr 14, 2006
Last updated
Mar 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC25567 CA Primary

Addresses

Primary practice location

601 N Euclid Ave
Ontario, CA 91762-3223

Mailing address

601 N Euclid Ave
Ontario, CA 91762-3223
Phone (909) 460-1100

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC25567CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
California Health and Rehab Center Corp. CurrentSince Mar 26, 2023 Accepting new patients
Joints Chiropractic LLC PastSince Aug 1, 2008 Accepting new patients
Ulta Care Gansert Chiropractic Professional Corporation Chiropractor Past Accepting new patients

Locations

601 N Euclid Ave
Ontario, CA 91762
Phone (909) 460-1100

Organizations & group practices 3

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1043274087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 N EUCLID AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917623223",
            "telephone_number": "909-460-1100",
            "fax_number": "909-460-0433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N EUCLID AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917623223",
            "telephone_number": "626-852-2268",
            "fax_number": "909-687-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANSERT",
        "first_name": "KEVIN",
        "middle_name": "KARL",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC25567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.