Active NPI
Jeffery Bernard Kiddy, DC
- Chiropractor
- Chula Vista, CA
National Provider Identifier
1245246578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC 12202
- Practice address
- 401 H St Ste 1
Chula Vista, CA 91910-4331 - Phone
- (619) 420-8430
- Fax
- (619) 420-8230
- NPI assigned
- Jul 31, 2006
- 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 | DC 12202 | CA | Primary |
Addresses
Primary practice location
401 H St Ste 1
Chula Vista, CA 91910-4331
Mailing address
401 H St Ste 1
Chula Vista, CA 91910-4331
Phone (619) 420-8430
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
| License | State | Type | Specialty |
|---|---|---|---|
| DC 12202 | CA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Doc Kiddy Chiropractic, PC | Chiropractor | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Chiropractor
- Chula Vista, CA
- NPI 1154488500
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245246578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 H ST STE 1",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919104331",
"telephone_number": "619-420-8430",
"fax_number": "619-420-8230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 H ST STE 1",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919104331",
"telephone_number": "619-420-8430",
"fax_number": "619-420-8230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIDDY",
"first_name": "JEFFERY",
"middle_name": "BERNARD",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC 12202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chula Vista, CA
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.