Kyle K Parrilla, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038013254 Issued in IL

Practice address

916 Talon Dr Ste 102
O Fallon, IL 62269-1848

Phone

(618) 628-8211

Fax

(618) 628-0883

NPI assigned

Aug 10, 2018

Last updated

Aug 10, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Khalsa Chiropractic Office P.C.Group PAC ID 1456416882, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Khalsa Chiropractic Office P.C.

  • Chiropractor
  • Cambridge, MA
  • NPI 1952430589
  Medicare reassignment Care Compare group NPD
• Sports Group Physical Therapy

  • Physical Therapy Clinic/Center
  • Cambridge, MA
  • NPI 1316395361
  NPD (past)

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

{
    "created_epoch": "1533859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533859200000",
    "number": "1073092029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 TALON DR STE 102",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691848",
            "telephone_number": "618-628-8211",
            "fax_number": "618-628-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 TALON DR STE 102",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691848",
            "telephone_number": "618-628-8211",
            "fax_number": "618-628-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARRILLA",
        "first_name": "KYLE",
        "middle_name": "K",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-10",
        "last_updated": "2018-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038013254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE II NPI",
            "identifier": "1811940893",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Summit Subhash Pandat, M.D.
• Kacey Panyik, APN CNM
• Shannon Delaney Parimi, M.D.
• Parker Roustio DMD Inc.
• Jaylen Alexander Parks
• Gerald Paskert
• Jerica Renee Patek
• Prabhudev Patil
• PC Associates LLC
• PC Associates, LLC

• Chiropractor in O'Fallon, IL
• Providers in O'Fallon, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2018; 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.