Tyson Laverne Klinedinst, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038011647 Issued in IL

Practice address

106 Martin Ave
Canton, IL 61520-2519

Phone

(309) 647-8030

Fax

(309) 647-5902

NPI assigned

Mar 16, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Klinedinst Chiropractic, LLCGroup PAC ID 5991837247, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Klinedinst Chiropractic, LLC

  • Chiropractor
  • Canton, IL
  • NPI 1972703627
  Medicare reassignment Care Compare group NPD
• Watson Center for Wellness Inc

  • Clinical Social Worker
  • Canton, IL
  • NPI 1114382652
  NPD (past)

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

{
    "created_epoch": "1268697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420502400000",
    "number": "1053635318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 MARTIN AVE",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202519",
            "telephone_number": "309-647-8030",
            "fax_number": "309-647-5902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MARTIN AVE",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202519",
            "telephone_number": "309-647-8030",
            "fax_number": "309-647-5902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINEDINST",
        "first_name": "TYSON",
        "middle_name": "LAVERNE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-16",
        "last_updated": "2015-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Lea Kerans, APN
• Jae K Kim, M.D.
• Amanda Sue Kinne, RPH
• Klinedinst Chiropractic, LLC
• Randy Laverne Klinedinst, D.C.
• Kathryn Knott, PT
• Rachel Kost
• Kenneth R. Krock, MD
• Abena Krow-Goossen, MD
• Chad Lampe, MD

• Chiropractor in Canton, IL
• Providers in Canton, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; 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.