Organization Active NPI

Dynamic Chiropractic LLC

  • Chiropractor
  • Blue Springs, MO
National Provider Identifier
1205309242
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
DYNAMIC CHIROPRACTIC LLC
Practice address
2525 NW South Outer Rd Ste C
Blue Springs, MO 64015-1726
Phone
(816) 800-8305
Fax
(816) 307-7279
NPI assigned
Jan 2, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Authorized official

Name
Dr. Dillon James Martinek, DCNPI 1497228423
Title
Chiropractic Physician
Phone
(816) 457-7135

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

2525 NW South Outer Rd Ste C
Blue Springs, MO 64015-1726

Mailing address

2525 NW South Outer Rd Ste C
Blue Springs, MO 64015-1726
Phone (816) 800-8305

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190723002535 MO Part B Supplier - Clinic/Group Practice 5294061602 Receives reassigned benefits from 3 practitioners
Practice locations: Blue Springs, MO

National Provider Directory

National Provider Directory

Locations

2525 NW South Outer Rd
Blue Springs, MO 64015

2525 NW South Outer Rd
Ste C
Blue Springs, MO 64015
Phone (816) 800-8305

1200 NW South Outer Rd
Ste 220
Blue Springs, MO 64015
Phone (816) 800-8305

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1546387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1205309242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 NW SOUTH OUTER RD STE C",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640151726",
            "telephone_number": "816-800-8305",
            "fax_number": "816-307-7279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 NW SOUTH OUTER RD STE C",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640151726",
            "telephone_number": "816-800-8305",
            "fax_number": "816-307-7279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-02",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "MARTINEK",
        "authorized_official_first_name": "DILLON",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN",
        "authorized_official_telephone_number": "816-457-7135",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Springs, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.