Active NPI
Derrick W. Kimball, D.C.
- Chiropractor
- Sedan, KS
National Provider Identifier
1215978093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 0104971
- Practice address
- 127 N Chautauqua St
Sedan, KS 67361-1301 - Phone
- (620) 725-5700
- Fax
- (620) 725-5700
- NPI assigned
- Jun 10, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 0104971 | KS | Primary |
Addresses
Primary practice location
127 N Chautauqua St
Sedan, KS 67361-1301
Mailing address
127 N Chautauqua St
Sedan, KS 67361-1301
Phone (620) 725-5700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0104971 | KS | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Medical Group | Past | Accepting new patients | |
| Anderson County Family Chiropractic, L.L.C. | Chiropractor | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215978093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 N CHAUTAUQUA ST",
"city": "SEDAN",
"state": "KS",
"postal_code": "673611301",
"telephone_number": "620-725-5700",
"fax_number": "620-725-5700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "127 N CHAUTAUQUA ST",
"city": "SEDAN",
"state": "KS",
"postal_code": "673611301",
"telephone_number": "620-725-5700",
"fax_number": "620-725-5700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMBALL",
"first_name": "DERRICK",
"middle_name": "W.",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "KS",
"license": "0104971",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sedan, KS
- Chautauqua County Home Health Agency
- Chautauqua Hills Dental Group
- County of Chautauqua
- Gabriel Wurdeman (Chautauqua Hills Dental Center)
- H&G&K Phcy Inc (Sedan Pharmacy)
- Kisa Life Recovery, LLC
- Bethany Anne Lear, RD, LD
- Levi Lear, PA-C
- Wade Matherly, P.A.
- Pharmacy Innovations LLC (Creative Health Pharmacy of Sedan)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.