Kenneth a. Nilsson, D.C. and Chiropractic Sports Therapy Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

KENNETH A. NILSSON, D.C. AND CHIROPRACTIC SPORTS THERAPY INC.

Practice address

2817 E Chapman Ave
Orange, CA 92869-3210

Phone

(714) 771-7171

NPI assigned

Nov 20, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Nilsson, DCNPI 1962628560

Title

Owner

Phone

(949) 677-8423

Specialties & licenses 1

Addresses

Other names 1

• kenneth Nilsson Former legal business name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth Alf Nilsson, D.C.

  • Chiropractor
  • Orange, CA
  • NPI 1962628560
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605830400000",
    "number": "1114520087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 E CHAPMAN AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928693210",
            "telephone_number": "714-771-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 E CHAPMAN AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928693210",
            "telephone_number": "714-771-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH A. NILSSON, D.C. AND CHIROPRACTIC SPORTS THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-20",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-15",
        "status": "A",
        "authorized_official_last_name": "NILSSON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-677-8423",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "kenneth Nilsson",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Russell A. Kelly, DDS
• Leah Kendall, OTR/L, CHT
• Chloe Kennedy
• Justine Kennedy
• Deborah Anne Kennemur, PH.D
• Kenneth Meng, a Medical Corporation
• Chelese Ann Kenny
• Jocelyne G Kent, OTR/L
• Nikhil Keny
• Nicole Felice Kepawitono

• Chiropractor in Orange, CA
• Providers in Orange, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.