Individual provider Active NPI

Kevin Aubrey Rosenlund, D.C.

  • Chiropractor
  • Kuna, ID
National Provider Identifier
1174560346
Registry record updated Feb 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA -942 Issued in ID
Practice address
675 W 4TH St
Kuna, ID 83634-1939
Phone
(208) 922-5057
Fax
(208) 922-5087
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIA -942 ID Primary

Addresses

Primary practice location

675 W 4TH St
Kuna, ID 83634-1939

Mailing address

PO Box 215
Kuna, ID 83634-0215
Phone (208) 922-5057

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050106000352 ID Practitioner - Chiropractic 3971551961 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIA -942IDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Kuna Chiropractic Family Care Center PC Chiropractor CurrentSince Apr 1, 2004 Accepting new patients

Organizations & group practices 1

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": "1361404800000",
    "number": "1174560346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 215",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "836340215",
            "telephone_number": "208-922-5057",
            "fax_number": "208-922-5087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 W 4TH ST",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "836341939",
            "telephone_number": "208-922-5057",
            "fax_number": "208-922-5087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENLUND",
        "first_name": "KEVIN",
        "middle_name": "AUBREY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2013-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA -942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kuna, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; 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.