Individual provider Active NPI

Amy Van, DC

  • Chiropractor
  • Overland Park, KS
National Provider Identifier
1104540053
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2022020675 Issued in MO
Practice address
14201 Metcalf Ave
Overland Park, KS 66223-3367
Phone
(913) 814-9494
NPI assigned
Oct 3, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2022020675 MO Primary

Addresses

Primary practice location

14201 Metcalf Ave
Overland Park, KS 66223-3367

Mailing address

814 W Morrow St
Marshall, MO 65340-2968
Phone (660) 815-7176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221031000096 KS Practitioner - Chiropractic 3678940996 Reassigns benefits to 1 organization
I20230322000597 MO Practitioner - Chiropractic 3678940996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

302 W Morgan St
Marshall, MO 65340-1930
Phone (660) 851-1878

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2022020675MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lionsgate Chiropractic Center for Wellness PA Chiropractor CurrentSince Oct 26, 2022 Accepting new patients
Van Chiropractic LLC Chiropractor CurrentSince Jan 1, 2023 Accepting new patients

Locations

14201 Metcalf Ave
Overland Park, KS 66223
Phone (913) 648-8600

302 W Morgan St
Marshall, MO 65340
Phone (660) 851-1878

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": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1104540053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 W MORROW ST",
            "city": "MARSHALL",
            "state": "MO",
            "postal_code": "653402968",
            "telephone_number": "660-815-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14201 METCALF AVE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662233367",
            "telephone_number": "913-814-9494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN",
        "first_name": "AMY",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2022020675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; 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.