NPIMap

Organization Active NPI

Knoderer Chiropractic Center LLC

  • Chiropractor
  • Kettering, OH
National Provider Identifier
1265014294
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
KNODERER CHIROPRACTIC CENTER LLC
Practice address
3817 Wilmington Pike
Kettering, OH 45429-5043
Phone
(937) 298-9039
NPI assigned
Apr 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Authorized official

Name
Dr. Benjamin Jeffrey Knoderer, DCNPI 1649643453
Title
Chiropractor
Phone
(937) 875-7257

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

3817 Wilmington Pike
Kettering, OH 45429-5043

Mailing address

3817 Wilmington Pike
Kettering, OH 45429-5043
Phone (937) 875-7257

Other names 1

  • Kettering Chiropractic Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210611000923 OH Part B Supplier - Clinic/Group Practice 5395145437 Receives reassigned benefits from 1 practitioner
Practice locations: Kettering, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619568000000",
    "number": "1265014294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3817 WILMINGTON PIKE",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454295043",
            "telephone_number": "937-875-7257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3817 WILMINGTON PIKE",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454295043",
            "telephone_number": "937-298-9039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNODERER CHIROPRACTIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A",
        "authorized_official_last_name": "KNODERER",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "JEFFREY",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "937-875-7257",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kettering Chiropractic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kettering, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.