Individual provider Active NPI

Kevin Stallbaumer, D.C.

  • Chiropractor
  • Overland Park, KS
National Provider Identifier
1164662722
Registry record updated Feb 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-05248 Issued in KS
Practice address
8764 W 95TH St
Overland Park, KS 66212-4049
Phone
(913) 738-6018
NPI assigned
Feb 23, 2009
Last updated
Feb 2, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01-05248 KS Primary

Addresses

Primary practice location

8764 W 95TH St
Overland Park, KS 66212-4049

Mailing address

8764 W 95TH St
Overland Park, KS 66212-4049
Phone (913) 738-6018

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090326000030 KS Practitioner - Chiropractic 7214094887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kevin Stallbaumer, D.C. LLCGroup PAC ID 8022337518, 2 clinicians

Practice addresses (Care Compare)

8764 W 95TH St
Overland Park, KS 66212-4049
Phone (913) 738-6018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01-05248KSMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Group of Overland Park LLC Chiropractor CurrentSince Apr 1, 2015 Accepting new patients
Kevin Stallbaumer, D.C. LLC Chiropractor CurrentSince Apr 30, 2013 Accepting new patients

Locations

8764 W 95th St
Overland Park, KS 66212
Phone (913) 383-2276

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": "1235347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422835200000",
    "number": "1164662722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8764 W 95TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662124049",
            "telephone_number": "913-738-6018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8764 W 95TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662124049",
            "telephone_number": "913-738-6018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLBAUMER",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-23",
        "last_updated": "2015-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2015; 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.