Individual provider Active NPI

Kenneth Allen Gilman, D.C.

  • Chiropractor
  • Clarksville, TN
National Provider Identifier
1093798787
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC0000001555 Issued in TN
Practice address
1636 Madison St
Clarksville, TN 37043-4911
Phone
(931) 647-3692
Fax
(931) 647-0279
NPI assigned
Nov 28, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC0000001555 TN Primary

Addresses

Primary practice location

1636 Madison St
Clarksville, TN 37043-4911

Mailing address

1636 Madison St
Clarksville, TN 37043-2977
Phone (931) 647-3692

Other identifiers 4

IdentifierTypeStateIssuer
166425100OtherTNU.S. DEPT OF LABOR
1356690754OtherTNNPI FOR GROUP
3125516OtherTNBLUECROSS BLUESHIELD
350046998OtherTNRAILROAD BENEFICIARY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120125000470 TN Practitioner - Chiropractic 0547171597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1636 Madison St
Suite a
Clarksville, TN 37043-4934
Phone (931) 647-3692

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1555TNMDMarriage & Family Therapist
DC0000001555TNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
The Point Surgical PLLC Current Accepting new patients
Clarksville Family Chiropractic Chiropractor PastSince May 18, 1999 Accepting new patients

Organizations & group practices 3

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": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1093798787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1636 MADISON ST",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370432977",
            "telephone_number": "931-647-3692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1636 MADISON ST",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434911",
            "telephone_number": "931-647-3692",
            "fax_number": "931-647-0279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMAN",
        "first_name": "KENNETH",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC0000001555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U.S. DEPT OF LABOR",
            "identifier": "166425100",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FOR GROUP",
            "identifier": "1356690754",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "3125516",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD BENEFICIARY",
            "identifier": "350046998",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; 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.