Individual provider Active NPI

Kenneth Michael Schmitt-Matzen, D.C.

  • Chiropractor
  • Cookeville, TN
National Provider Identifier
1114068186
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC0000000407 Issued in TN
Practice address
132 S Lowe Ave
Cookeville, TN 38501-4701
Phone
(931) 526-3151
NPI assigned
Feb 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC0000000407 TN Primary

Addresses

Primary practice location

132 S Lowe Ave
Cookeville, TN 38501-4701

Mailing address

132 S Lowe Ave
Cookeville, TN 38501-4701
Phone (931) 526-3151

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111128000007 TN Practitioner - Chiropractic 8123292356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

132 S Lowe Ave
Cookeville, TN 38501-4701
Phone (931) 202-3130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cookeville Chiropractic and Physical Therapy, P.C. CurrentSince Mar 22, 2002 Accepting new patients
Cookeville Chiropractic & Physical Therapy, P. C. Chiropractor Past Accepting new patients

Locations

132 S Lowe Ave
Cookeville, TN 38501
Phone (931) 202-3130

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": "1171065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114068186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 S LOWE AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014701",
            "telephone_number": "931-526-3151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 S LOWE AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014701",
            "telephone_number": "931-526-3151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMITT-MATZEN",
        "first_name": "KENNETH",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC0000000407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.