Individual provider Active NPI

Osama M Kassab, DC

  • Chiropractor
  • Greenwood Village, CO
National Provider Identifier
1225589807
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHR.0007709 Issued in CO
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, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
I20181005000263 CO Practitioner - Chiropractic 8325390115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AT.0001913COMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
CHC NCS, LLC CurrentSince Jul 7, 2020 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.

Verify at the official NPI Registry.