Active NPI
Kenneth Ryan Rozell, D.C.
- Chiropractor
- Edwardsville, IL
National Provider Identifier
1073061156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 038.013029
- Practice address
- 3 Sunset Hills Professional Center
Suite 2
Edwardsville, IL 62025 - Phone
- (618) 709-2401
- NPI assigned
- Sep 16, 2016
- Last updated
- Aug 15, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038.013029 | IL | Primary |
Addresses
Primary practice location
3 Sunset Hills Professional Center
Suite 2
Edwardsville, IL 62025
Mailing address
2725 James Sanders Blvd
Ste B
Paducah, KY 42001-8405
Phone (618) 709-2401
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038.013029 | IL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502755200000",
"number": "1073061156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2725 JAMES SANDERS BLVD",
"address_2": "STE B",
"city": "PADUCAH",
"state": "KY",
"postal_code": "420018405",
"telephone_number": "618-709-2401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 SUNSET HILLS PROFESSIONAL CENTER",
"address_2": "SUITE 2",
"city": "EDWARDSVILLE",
"state": "IL",
"postal_code": "62025",
"telephone_number": "618-709-2401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROZELL",
"first_name": "KENNETH",
"middle_name": "RYAN",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-09-16",
"last_updated": "2017-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038.013029",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edwardsville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.