Active NPI
Kenneth Gillanders, D.C.
- Chiropractor
- Fresno, CA
National Provider Identifier
1114008885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC22934
- Practice address
- 2755 E Shaw Ave
Ste 104
Fresno, CA 93710-8230 - Phone
- (559) 226-0338
- Fax
- (559) 226-3716
- NPI assigned
- Oct 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC22934 | CA | Primary |
Addresses
Primary practice location
2755 E Shaw Ave
Ste 104
Fresno, CA 93710-8230
Mailing address
2755 E Shaw Ave
Ste 104
Fresno, CA 93710-8230
Phone (559) 226-0338
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DC0229340 | Other | CA | BLUE SHIELD |
| DC0229340 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC22934 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471305600000",
"number": "1114008885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2755 E SHAW AVE",
"address_2": "STE 104",
"city": "FRESNO",
"state": "CA",
"postal_code": "937108230",
"telephone_number": "559-226-0338",
"fax_number": "559-226-3716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2755 E SHAW AVE",
"address_2": "STE 104",
"city": "FRESNO",
"state": "CA",
"postal_code": "937108230",
"telephone_number": "559-226-0338",
"fax_number": "559-226-3716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLANDERS",
"first_name": "KENNETH",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-18",
"last_updated": "2016-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC22934",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "DC0229340",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DC0229340",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.