Individual provider Active NPI

Darwin M Prosak, DC

  • Chiropractor
  • Kansas City, MO
National Provider Identifier
1235274408
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
003749 Issued in MO
Practice address
222 W Gregory Blvd
Suite 110
Kansas City, MO 64114-1127
Phone
(816) 523-3585
NPI assigned
Feb 21, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 003749 MO Primary

Addresses

Primary practice location

222 W Gregory Blvd
Suite 110
Kansas City, MO 64114-1127

Mailing address

222 W Gregory Blvd
Suite 110
Kansas City, MO 64114-1127
Phone (816) 523-3585

Other identifiers 1

IdentifierTypeStateIssuer
12906012OtherMOBLUE CROSS

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
03242KSMDCounseling Psychologist
003749MOMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235274408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W GREGORY BLVD",
            "address_2": "SUITE 110",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641141127",
            "telephone_number": "816-523-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W GREGORY BLVD",
            "address_2": "SUITE 110",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641141127",
            "telephone_number": "816-523-3585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROSAK",
        "first_name": "DARWIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "003749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "12906012",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

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.

Verify at the official NPI Registry.