Individual provider Active NPI

Kyle J Lawson, DC, MS, CFMP

  • Chiropractor
  • San Angelo, TX
National Provider Identifier
1063185908
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
14861 Issued in TX
Practice address
2926 Sherwood Way Ste 100
San Angelo, TX 76901-3511
Phone
(325) 208-4842
NPI assigned
Jul 27, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 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 14861 TX Primary

Addresses

Primary practice location

2926 Sherwood Way Ste 100
San Angelo, TX 76901-3511

Mailing address

2753 Dena Dr
San Angelo, TX 76904-5075
Phone (512) 653-1767

Other identifiers 1

IdentifierTypeStateIssuer
14861OtherTXCHIROPRACTIC LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240802002109 MN Practitioner - Chiropractic 9032656434 Reassigns benefits to 1 organization
I20240802002197 WI Practitioner - Chiropractic 9032656434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Gregory W Bernard DC PAGroup PAC ID 3476864679, 3 clinicians

Practice addresses (Care Compare)

14727 60TH St N
Stillwater, MN 55082-6323
Phone (651) 571-0201

1500 Madison Ave
Suite 5a
New Richmond, WI 54017-6693
Phone (751) 322-3794

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
14861TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Nielson Family Chiropractic PLLC Chiropractor CurrentSince Jun 23, 2024 Accepting new patients
Gregory W Bernard DC PA Chiropractor CurrentSince Jun 23, 2024 Accepting new patients

Locations

14727 60th St N
Stillwater, MN 55082
Phone (651) 439-1013

1500 Madison Ave
Ste 5A
New Richmond, WI 54017
Phone (715) 941-0277

101 N Main St
River Falls, WI 54022
Phone (651) 571-0201

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1063185908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2753 DENA DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769045075",
            "telephone_number": "512-653-1767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2926 SHERWOOD WAY STE 100",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769013511",
            "telephone_number": "325-208-4842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWSON",
        "first_name": "KYLE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DC, MS, CFMP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-27",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "14861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC LICENSE",
            "identifier": "14861",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.