Individual provider Active NPI

Aaron Kimball, DC

  • Chiropractor
  • Fort Wayne, IN
National Provider Identifier
1083500557
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08003520A Issued in IN
Practice address
12812 Coldwater Rd Ste 101
Fort Wayne, IN 46845-9516
Phone
(260) 445-8389
Fax
(877) 919-8689
NPI assigned
Jun 13, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08003520A IN Primary

Addresses

Primary practice location

12812 Coldwater Rd Ste 101
Fort Wayne, IN 46845-9516

Mailing address

12812 Coldwater Rd Ste 101
Fort Wayne, IN 46845-9516
Phone (260) 445-8389

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250701000662 IN Practitioner - Chiropractic 5193238335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2025
Medicare assignment
May accept Medicare assignment
Group practices
Crossroads Wellness Center, LLCGroup PAC ID 6406195593, 5 clinicians

Practice addresses (Care Compare)

12812 Coldwater Rd
Suite 101
Fort Wayne, IN 46845-9516
Phone (260) 445-8389

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08003520AINMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Burns Physical Therapy and Wellness Company CurrentSince Jun 12, 2025 Accepting new patients
Crossroads Wellness Center, LLC Chiropractor CurrentSince Jun 12, 2025 Accepting new patients

Locations

12812 Coldwater Rd
#101
Fort Wayne, IN 46845
Phone (260) 445-8389

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1749772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1083500557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12812 COLDWATER RD STE 101",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468459516",
            "telephone_number": "260-445-8389",
            "fax_number": "877-919-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12812 COLDWATER RD STE 101",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468459516",
            "telephone_number": "260-445-8389",
            "fax_number": "877-919-8689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-13",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08003520A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2025; 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.