Individual provider Active NPI

Kenneth Karlus D'Souza, D.C.

  • Chiropractor
  • Midlothian, VA
National Provider Identifier
1083921092
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104556816 Issued in VA
Practice address
2342 Colony Crossing PL
Midlothian, VA 23112-4280
Phone
(804) 744-4317
Fax
(804) 744-4318
NPI assigned
Sep 13, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH13806 FL
Chiropractor 111N00000X 0104556816 VA Primary

Addresses

Primary practice location

2342 Colony Crossing PL
Midlothian, VA 23112-4280

Mailing address

2342 Colony Crossing PL
Midlothian, VA 23112-4280
Phone (804) 744-4317

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231005002847 FL Practitioner - Chiropractic 7214190214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5204 Paylor LN
Lakewood Ranch, FL 34240-2204
Phone (941) 355-0299

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Balance 4 Life Chiropractic Chiropractor CurrentSince Sep 1, 2023 Accepting new patients
Balance 4 Life Chiropractic, Inc. Chiropractor PastSince Apr 18, 2012 Accepting new patients

Locations

5204 Paylor Ln
Lakewood Ranch, FL 34240
Phone (941) 355-0299

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": "1284336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1083921092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2342 COLONY CROSSING PL",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231124280",
            "telephone_number": "804-744-4317",
            "fax_number": "804-744-4318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2342 COLONY CROSSING PL",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231124280",
            "telephone_number": "804-744-4317",
            "fax_number": "804-744-4318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'SOUZA",
        "first_name": "KENNETH",
        "middle_name": "KARLUS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-13",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH13806",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.