Kevin Russell Mikalaitis

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHR-6064 Issued in CO

Practice address

1318 Vivian St
Longmont, CO 80501-3217

Phone

(303) 776-0882

Fax

(303) 776-1053

NPI assigned

Nov 27, 2007

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

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - West Sunnyvale, 2005

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Optimize Health 360

  • Rehabilitation Chiropractor
  • Marco Island, FL
  • NPI 1013799550
  NPD (past)

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199664000000",
    "number": "1104008663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 VIVIAN ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805013217",
            "telephone_number": "303-776-0882",
            "fax_number": "303-776-1053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 VIVIAN ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805013217",
            "telephone_number": "303-776-0882",
            "fax_number": "303-776-1053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKALAITIS",
        "first_name": "KEVIN",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-27",
        "last_updated": "2008-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "CHR-6064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael J Kellogg DDS PC
• Michael R Christopher DMD LLC
• Michele Forsberg PT, PC
• Kelli Middleton, PTA
• Laurissa Miech
• Lisa L Mikesell, LCSW CACIII
• Kristen Mildenberger, LCSW
• Milestone Medical Group Inc
• Denise M Miller, MD
• Laurel Mackey Miller, DIPL. AC.

• Chiropractor in Longmont, CO
• Providers in Longmont, CO by specialty
• Chiropractor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; 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.