Organization Active NPI

Kenneth E Degroot DC Inc

Doing business as de Groot Chiropractic

  • Chiropractor
  • Wilmington, DE
National Provider Identifier
1215156070
Registry record updated Sep 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
F10000191 Issued in DE
Legal business name
KENNETH E DEGROOT DC INC
Doing business as
de Groot Chiropractic
Practice address
1401 Silverside Rd
Suite 1
Wilmington, DE 19810-4400
Phone
(302) 475-5600
Fax
(302) 475-5940
NPI assigned
Apr 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2012

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

Authorized official

Name
Dr. Kenneth Eric De Groot, D.O.NPI 1730254921
Title
Owner
Phone
(302) 475-5600

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 F10000191 DE Primary

Addresses

Primary practice location

1401 Silverside Rd
Suite 1
Wilmington, DE 19810-4400

Mailing address

1401 Silverside Rd
Suite 1
Wilmington, DE 19810-4400
Phone (302) 475-5600

Other identifiers 2

IdentifierTypeStateIssuer
0001073718MedicaidDE
2279331000OtherDEAMERIHEALTH

Other names 1

  • de Groot Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081018000215 DE Part B Supplier - Clinic/Group Practice 2062570195 Receives reassigned benefits from 1 practitioner
Practice locations: Wilmington, DE

National Provider Directory

National Provider Directory

Locations

1401 Silverside Rd
Ste 1
Wilmington, DE 19810
Phone (302) 475-5600

Interoperability endpoints

  • Direct secure messaging: kdegdc@docc0001.direct.chirotouch.md

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346716800000",
    "number": "1215156070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 SILVERSIDE RD",
            "address_2": "SUITE 1",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104400",
            "telephone_number": "302-475-5600",
            "fax_number": "302-475-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 SILVERSIDE RD",
            "address_2": "SUITE 1",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104400",
            "telephone_number": "302-475-5600",
            "fax_number": "302-475-5940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH E DEGROOT DC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2012-09-04",
        "status": "A",
        "authorized_official_last_name": "DE GROOT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-475-5600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "DE",
            "license": "F10000191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001073718",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "2279331000",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "de Groot Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; 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.