KC Spine, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

01-05902 Issued in KS

Legal business name

KC SPINE, LLC

Doing business as

KC Spine

Practice address

1707 E Cedar St Ste 108
Olathe, KS 66062-1886

Phone

(913) 318-3003

NPI assigned

Jul 13, 2018

Last updated

Mar 19, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Cameon M Blake, DCNPI 1386130839

Title

Owner / Chiropractor

Phone

(913) 475-5193

Specialties & licenses 1

Addresses

Other names 2

• KC Spine Doing business as
• Clear Wave Chiropractic Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Cameon Michelle Blake, DC

  • Chiropractor
  • Olathe, KS
  • NPI 1386130839
  NPD Authorized official

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

{
    "created_epoch": "1531440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552953600000",
    "number": "1184100034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12482 SLATER LN",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662131773",
            "telephone_number": "913-475-5193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 E CEDAR ST STE 108",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621886",
            "telephone_number": "913-318-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KC SPINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-13",
        "last_updated": "2019-03-19",
        "status": "A",
        "authorized_official_last_name": "BLAKE",
        "authorized_official_first_name": "CAMEON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER / CHIROPRACTOR",
        "authorized_official_telephone_number": "913-475-5193",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KC Spine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clear Wave Chiropractic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Kenton G Kaufman, M.D.
• Lynn Waldman Kaufman
• Olivia D Kaufman
• Caitlin M Kazelis, M.S.
• KC Mobile Health, LLC
• Mary Katherine Keenan, M.S., CCC-SLP
• Keepers Legacy Home Care Services LLC
• Morgan Alexis Keesee, PT, DPT
• Eric J Keiter, PA
• Melina Keithly, DO

• Chiropractor in Olathe, KS
• Providers in Olathe, KS by specialty
• Chiropractor in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.