Active NPI
Osama M Kassab, DC
- Chiropractor
- Greenwood Village, CO
National Provider Identifier
1225589807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHR.0007709
- Practice address
- 5690 DTC Blvd Ste 140E
Greenwood Village, CO 80111 - Phone
- (303) 847-0905
- NPI assigned
- Oct 19, 2016
- Reactivated
- Sep 11, 2018
- Last updated
- Sep 18, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT.0001913 | CO | |
| Chiropractor | 111N00000X | CHR.0007709 | CO | Primary |
Addresses
Primary practice location
5690 DTC Blvd Ste 140E
Greenwood Village, CO 80111
Mailing address
14566 Domino St
Parker, CO 80134-4066
Phone (303) 829-7483
Other practice location 1
5690 Dtc Blvd Ste 140E
Greenwood Village, CO 80111
Phone (303) 847-0905
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181005000263 | CO | Practitioner - Chiropractic | 8325390115 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT.0001913 | CO | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CHC NCS, LLC | Current | Accepting new patients |
Locations
11681 Voyager Pkwy
Ste 110
Colorado Springs, CO 80921
Phone (719) 510-6730
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537228800000",
"number": "1225589807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14566 DOMINO ST",
"city": "PARKER",
"state": "CO",
"postal_code": "801344066",
"telephone_number": "303-829-7483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5690 DTC BLVD STE 140E",
"city": "GREENWOOD VILLAGE",
"state": "CO",
"postal_code": "80111",
"telephone_number": "303-847-0905"
}
],
"practiceLocations": [
{
"address_1": "5690 Dtc Blvd Ste 140E",
"address_purpose": "LOCATION",
"city": "Greenwood Village",
"state": "CO",
"postal_code": "80111",
"country_code": "US",
"telephone_number": "303-847-0905",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KASSAB",
"first_name": "OSAMA",
"middle_name": "M",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-19",
"last_updated": "2018-09-18",
"deactivation_date": "2018-07-26",
"reactivation_date": "2018-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CO",
"license": "AT.0001913",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CO",
"license": "CHR.0007709",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Greenwood Village, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; 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.