Abundant Life Chiropractic PA
Organization Active NPI Chiropractor · Kansas City, KS
NPI 1063600518 · NPPES record last updated Feb 1, 2012
Key facts
- NPI
- 1063600518
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 4742 (KS)
- Legal business name
- ABUNDANT LIFE CHIROPRACTIC PA
- Practice address
- 2300 Hutton Rd
Suite 101
Kansas City, KS 66109-4403 - Phone
- (913) 721-0060
- Fax
- (913) 721-2553
- NPI assigned
- Oct 10, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Wendy Ann Briley, D.C.
- Title
- Owner
- Phone
- (913) 721-0060
Practitioners 2
-
Wendy Ann Brakhage, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071115000637 | KS | Part B Supplier - Clinic/Group Practice | 1254429798 |
Receives reassigned benefits from 2 practitioners Practice locations: Kansas City, KS |
National Provider Directory
Locations
2300 Hutton Rd
Ste 101
Kansas City, KS 66109
Phone (913) 721-0060
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 4742 | KS | Yes |
Addresses
Primary practice location
2300 Hutton Rd
Suite 101
Kansas City, KS 66109-4403
Mailing address
2300 Hutton Rd
Suite 101
Kansas City, KS 66109-4403
Phone (913) 721-0060
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 27743036 | Other | KS | BLUE CROSS BLUE SHIELD |
Other providers in Kansas City, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.