Individual provider Active NPI

Christine M. Kmiec, D.C.

  • Chiropractor
  • Scranton, PA
National Provider Identifier
1265404347
Registry record updated May 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
008926 Issued in PA
Practice address
371 N 9TH Ave
Scranton, PA 18504-2005
Phone
(570) 558-2225
Fax
(570) 558-6325
NPI assigned
Feb 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 008926 PA Primary

Addresses

Primary practice location

371 N 9TH Ave
Scranton, PA 18504-2005

Mailing address

371 N 9TH Ave
Scranton, PA 18504-2005
Phone (570) 558-2225

Other identifiers 1

IdentifierTypeStateIssuer
001439457OtherPABLUECROSS BLUE SHIELD

Other names 1

  • Dr. Christine M Kmiec-Depietro Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050204000159 PA Practitioner - Chiropractic 7618928151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

371 N 9TH Ave
Scranton, PA 18504-2005
Phone (570) 558-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008926PAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Active Health Chiropractic LLC CurrentSince Jun 15, 2011 Accepting new patients
Advanced Chiropractic of Milford Chiropractor Past Accepting new patients

Locations

371 N 9th Ave
Scranton, PA 18504
Phone (570) 558-2225

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305763200000",
    "number": "1265404347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 N 9TH AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185042005",
            "telephone_number": "570-558-2225",
            "fax_number": "570-558-6325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 N 9TH AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185042005",
            "telephone_number": "570-558-2225",
            "fax_number": "570-558-6325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KMIEC",
        "first_name": "CHRISTINE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-03",
        "last_updated": "2011-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "008926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUE SHIELD",
            "identifier": "001439457",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "KMIEC-DEPIETRO",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Scranton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.