Individual provider Active NPI

Kenneth Samuel Glover III, D.C.

  • Chiropractor
  • Gardendale, AL
National Provider Identifier
1144673864
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2506 Issued in AL
Practice address
1016 Mulberry LN
Gardendale, AL 35071-2468
Phone
(205) 631-9899
NPI assigned
Jul 18, 2016
Last updated
Mar 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2506 AL Primary

Addresses

Primary practice location

1016 Mulberry LN
Gardendale, AL 35071-2468

Mailing address

1016 Mulberry LN
Gardendale, AL 35071-2468
Phone (205) 631-9899

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160804002538 AL Practitioner - Chiropractic 8729372370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1016 Mulberry LN
Gardendale, AL 35071-2468
Phone (205) 631-9989

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2506ALMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Glover Chiropractic LLC Chiropractor CurrentSince Mar 16, 2023 Accepting new patients
Healthchoice, LLC Chiropractor PastSince Mar 19, 2023 Accepting new patients

Locations

1016 Mulberry Ln
Gardendale, AL 35071
Phone (205) 631-9899

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1144673864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 MULBERRY LN",
            "city": "GARDENDALE",
            "state": "AL",
            "postal_code": "350712468",
            "telephone_number": "205-631-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 MULBERRY LN",
            "city": "GARDENDALE",
            "state": "AL",
            "postal_code": "350712468",
            "telephone_number": "205-631-9899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "KENNETH",
        "middle_name": "SAMUEL",
        "name_suffix": "III",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-18",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "2506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardendale, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.