Individual provider Active NPI

Jason Kistler, D.C.

  • Chiropractor
  • Malvern, PA
National Provider Identifier
1205280666
Registry record updated Apr 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC011041 Issued in PA
Practice address
477 Lancaster Ave
Unit 106
Malvern, PA 19355-3602
Phone
(717) 554-6097
NPI assigned
Apr 21, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC011041 PA Primary

Addresses

Primary practice location

477 Lancaster Ave
Unit 106
Malvern, PA 19355-3602

Mailing address

14960 Schooner Bay LN
Apt 21106
Naples, FL 34119-7780
Phone (717) 554-6097

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160616001763 PA Practitioner - Chiropractic 4587954383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

477 Lancaster Ave
Suite 106
Malvern, PA 19355-3602
Phone (717) 554-6097

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kistler Family Chiropractic, LLC Chiropractor CurrentSince May 1, 2016 Accepting new patients

Locations

477 Lancaster Ave
Ste 106
Malvern, PA 19355
Phone (717) 554-6097

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": "1461196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461196800000",
    "number": "1205280666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14960 SCHOONER BAY LN",
            "address_2": "APT 21106",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341197780",
            "telephone_number": "717-554-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 LANCASTER AVE",
            "address_2": "UNIT 106",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193553602",
            "telephone_number": "717-554-6097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISTLER",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-21",
        "last_updated": "2016-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC011041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malvern, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; 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.