Individual provider Active NPI

Kenneth Michael Gabriel, D.C.

  • Chiropractor
  • Salem, NH
National Provider Identifier
1063540383
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
632-0401 Issued in NH
Practice address
45 Stiles Rd
Suite 104
Salem, NH 03079-4808
Phone
(603) 893-1013
Fax
(603) 893-1298
NPI assigned
Feb 28, 2007
Last updated
Oct 17, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 632-0401 NH Primary
Chiropractor 111N00000X 2584 MA

Addresses

Primary practice location

45 Stiles Rd
Suite 104
Salem, NH 03079-4808

Mailing address

45 Stiles Rd
Suite 104
Salem, NH 03079-4808
Phone (603) 893-1013

Other identifiers 1

IdentifierTypeStateIssuer
Y36794OtherNHBCBS OF MASS.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060117000490 NH Practitioner - Chiropractic 2860416997 Practice locations: Salem, NH

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2 Manor Pkwy
Salem, NH 03079-4871
Phone (603) 893-1013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2584MAMDChiropractor
632-0401NHMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1063540383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 STILES RD",
            "address_2": "SUITE 104",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030794808",
            "telephone_number": "603-893-1013",
            "fax_number": "603-893-1298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 STILES RD",
            "address_2": "SUITE 104",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030794808",
            "telephone_number": "603-893-1013",
            "fax_number": "603-893-1298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABRIEL",
        "first_name": "KENNETH",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NH",
            "license": "632-0401",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "2584",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MASS.",
            "identifier": "Y36794",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.