Individual provider Active NPI

Mike V Kenkel, D.C.

  • Chiropractor
  • Glenwood, IA
National Provider Identifier
1124065123
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
06530 Issued in IA
Practice address
502 Sharp St
Glenwood, IA 51534-1731
Phone
(712) 527-5800
Fax
(712) 527-2065
NPI assigned
May 31, 2006
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 06530 IA Primary

Addresses

Primary practice location

502 Sharp St
Glenwood, IA 51534-1731

Mailing address

502 Sharp St
Glenwood, IA 51534-1731
Phone (712) 527-5800

Other identifiers 1

IdentifierTypeStateIssuer
3264648MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060209000270 IA Practitioner - Chiropractic 7618982976 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

407 Sharp St
Glenwood, IA 51534-1729
Phone (712) 527-5800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06530IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Kenkel Family Chiropractic PC Chiropractor CurrentSince Jan 4, 2006 Accepting new patients
Cedar Valley Medical Specialists PC Past Accepting new patients
Whitmer Spine & Sports Chiropractic Chiropractor PastSince Nov 30, 2012 Accepting new patients
Pitts Family & Sports Chiropractic CTRS PC Chiropractor PastSince Feb 1, 2003 Accepting new patients

Locations

407 Sharp St
Glenwood, IA 51534
Phone (712) 527-5800

502 Sharp St
Glenwood, IA 51534
Phone (712) 527-5800

Organizations & group practices 4

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124065123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 SHARP ST",
            "city": "GLENWOOD",
            "state": "IA",
            "postal_code": "515341731",
            "telephone_number": "712-527-5800",
            "fax_number": "712-527-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 SHARP ST",
            "city": "GLENWOOD",
            "state": "IA",
            "postal_code": "515341731",
            "telephone_number": "712-527-5800",
            "fax_number": "712-527-2065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENKEL",
        "first_name": "MIKE",
        "middle_name": "V",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3264648",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenwood, IA

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.