Individual provider Active NPI

Craig Edward Koshlap, D.C.

  • Chiropractor
  • Olathe, KS
National Provider Identifier
1063576023
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4897 Issued in KS
Practice address
17775 W 106TH St
Ste 105
Olathe, KS 66061-3197
Phone
(913) 890-7370
Fax
(913) 890-7372
NPI assigned
Dec 21, 2006
Last updated
Jul 21, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4897 KS Primary
Chiropractor 111N00000X CH 8111 FL
Chiropractor 111N00000X 2004020267 MO

Addresses

Primary practice location

17775 W 106TH St
Ste 105
Olathe, KS 66061-3197

Mailing address

17775 W 106TH St
Ste 105
Olathe, KS 66061-3197
Phone (913) 890-7370

Other identifiers 1

IdentifierTypeStateIssuer
34120027OtherMOBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040909000452 KS Practitioner - Chiropractic 3274509492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17775 W 106TH St
Suite 105
Olathe, KS 66061-3197
Phone (913) 890-7370

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4897KSMDClinical Social Worker
CH 8111FLMDChiropractor
2004020267MOMDChiropractor
8111FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgeview Chiropractic LLC Chiropractor CurrentSince May 23, 2011 Accepting new patients
Chiromed Chiropractic Center, Inc Chiropractor Past Accepting new patients
Dunedin Pediatrics LLC PastSince Oct 13, 2020 Accepting new patients
James a. Diienno, D.C., P.a. Chiropractor Past Accepting new patients
Thomas E. Forbach, D.C. Chiropractor Past Accepting new patients

Locations

17775 W 106th St
Ste 105
Olathe, KS 66061
Phone (913) 890-7370

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22512/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1063576023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17775 W 106TH ST",
            "address_2": "STE 105",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660613197",
            "telephone_number": "913-890-7370",
            "fax_number": "913-890-7372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17775 W 106TH ST",
            "address_2": "STE 105",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660613197",
            "telephone_number": "913-890-7370",
            "fax_number": "913-890-7372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSHLAP",
        "first_name": "CRAIG",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "4897",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 8111",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2004020267",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "34120027",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olathe, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.